NOTICE OF DEFAULT BY ASSIGNEE TO OBLIGOR

Date:
To:
Please take notice that you are in default in the amount of
dollars ($ ), having failed to make
the following payments due to me on the indebtedness of
dollars ($ ), described in and secured by an
assignment, dated , (year), made by
, assignor, to me and filed on , (year), in
County Clerk's Office, filing No. , and notice of which assignment was served on
you on , (year). The payments that you are in default are the following:
Unless such amounts or such payment thereon as I may accept are made within
days from the date of mailing of this notice, I will sue to collect.
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