Fill and Sign the Demand Notice Payment Form

Demand and Notice for Payment of Demand Promissory Note with FDCPA Validation Notice To: ___________________________ (Name of Lessee) ______________________________________ Street Address or Post Office Box ______________________________________ City, state, and zip code I am currently the holder of your promissory note dated _____________________ (date) in the amount of $______________ which is payable to he undersigned. By this notice, I am making a formal demand for payment by you of the full unpaid balance of this note, together with all accrued interest, within ten (10) days of receipt of this letter. The total amount due at this time is $__________________. Please contact me at the address and phone number below in order to initiate the payment process. If full payment is not received within ten (10) days from the date of this demand, the note shall be forwarded to our attorneys for legal collection proceedings and you will be immediately liable for all costs of collection, including any additional legal and court costs. Thank you very much for your prompt attention to this serious matter. THIS IS AN ATTEMPT TO COLLECT A DEBT AND ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE. Unless you contest the validity of this indebtedness in writing, I will assume that the debt is valid. Witness my signature this the ______ day of __________________, 20______. ____________________________________ (Name & Signature of Note Holder) ___________________________________ Street Address or Post Office Box) ___________________________________ (City, state, and zip code) __________________________ (Telephone Number)