Financial Crummy Letter

FINANCIAL CRUMMY LETTER

PARTIES AND CONTACT

ACCOUNT SUMMARY

Original Principal: $   Current Balance: $   Interest Rate (annual):

Last Posted Payment Date:   Days Past Due:

ITEMIZED LEDGER (MOST RECENT ACTIVITY)

DEMAND, OFFER, AND TERMS

This Financial Crummy Letter constitutes a formal demand for payment in respect of the account referenced above (Account Number: ). Creditor demands payment of the Current Balance set forth above in full no later than . If payment is not received by that date, the account will be subject to the remedies described below.

Settlement Offer: Creditor may agree to accept a reduced lump-sum payment of $ if received by . Acceptance of any settlement is conditioned on receipt of cleared funds and a signed settlement memorandum executed by Creditor.

Proposed Repayment Plan (if elected): Number of installments ; Frequency: ; Amount per installment $ . Creditor reserves the right to require a signed payment agreement and to assess one-time administrative fee of $ for processing.

PAYMENT METHODS & FEES

Accepted payment methods (select all that apply):

Check or cashier's check
ACH / Bank transfer
Credit / Debit card (card-processing fee may apply)
Wire transfer

Late Payment Fee: A late fee of or a minimum of $ (whichever is greater) will be applied to any payment received after the date due. Interest on delinquent balances will accrue at the rate specified above unless prohibited by law.

DEFAULT, REMEDIES, AND REPORTING

If the account remains unpaid or the parties fail to comply with a negotiated repayment plan, Creditor may take one or more of the following actions: assess additional fees and interest, refer the matter to collections, initiate legal proceedings to recover amounts due, obtain a judgment and pursue available execution remedies, and report the delinquency to consumer reporting agencies where authorized by law. Debtor will be responsible for collection costs, reasonable attorneys' fees, and court costs incurred by Creditor in enforcing its rights.

Security Interest: To the extent the underlying obligation is secured, Creditor reserves any and all rights under the security agreement and applicable law, including repossession or foreclosure where permitted.

DISPUTE AND CERTIFICATION

If Debtor disputes the validity or amount of this debt, Debtor must provide a written statement of dispute to Creditor at the address shown above within 30 days of receipt of this Letter. Failure to dispute in writing within that period will be deemed an admission of the debt amount set forth herein for purposes of collection. The undersigned certifies under penalty of perjury that the statements contained in this Letter are true and correct to the best of the undersigned's knowledge and that the amount demanded is owed by the named Debtor.

ACKNOWLEDGMENT OF RECEIPT (OPTIONAL)

Debtor may acknowledge receipt of this Financial Crummy Letter by returning a signed copy or by completing the acknowledgement below and returning it to Creditor. Acknowledgement received on:

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