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Installment Payment Acknowledgement

Date:

To: ________________________

________________________

________________________

We are pleased we could resolve your overdue balance by accepting your offer to pay your $_______________ balance in _______________ payments of $_______________ each. We anticipate receiving your first payment on _______________.

Please understand that should you miss any payment, we shall proceed to collect the entire balance then due. We have every confidence, however, that this will not be necessary.

We look forward to continuing business with you in the future.

If these terms meet with your understanding, please acknowledge below and return.

Very truly,

_____________________

Acknowledged: