Date:
Account Number: Balance Due: $
Dear __________:
This is a reminder that your account with our office is now past due. We would appreciate receiving payment in full from you immediately.
If you have a question or problem regarding this account, please call me and I will be happy to assist you.
If your check is in the mail, thank you and please disregard this reminder.
Sincerely,
___________________, Accounts Receivable Administrator
P.S. - For your convenience we also accept all major credit cards. To pay by credit card, please fill out the information at the bottom of this letter and return it to our office today.
Check Credit Card Type: __ VISA __ MasterCard __ Discover __ American Express
Credit Card Number ____________________ Expiration Date __________ Print Cardholder Name ___________________________________________
Cardholder Signature ____________________________________________
Amount Paid $ ______________ DRSI - first
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