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YOUR NAME

YOUR ADDRESS
CITY, STATE, ZIP
DATE:
COLLECTION AGENCY/LAW FIRM
ADDRESS
CITY, STATE, ZIP
This letter is being sent to you in response to a notice sent to me on DATE. Be advised that this is not a
refusal to pay, but a notice that your claim is disputed and validation of the alleged debt is requested.
As per the Fair Debt Collection Practices Act, 15 USC 1692g Sec. 809 (b), I have the right to request a
validation of this debt. I request you to prove that I am indeed the party who is by contract obligated to
pay off this debt.
In your response, please attach copies of the following documents:
1. Agreement with your client that authorizes you to collect on this alleged debt.
2. Original agreement that bears signature of the alleged debtor wherein he/she promises to pay the
original creditor.
3. Complete payment history on this account so as to prove that the debt amount you wish to collect is
correct, and that the statue of limitations for my state has not passed.
Until such time as the alleged debt is proven to be valid and the supporting documentation requested
above provided to me, I hereby demand that you cease any and all efforts to contact me, my relations,
my employer, and any other persons, businesses or entities regarding this alleged debt.
Furthermore, I hereby notify you that my employer prohibits incoming and outgoing personal phone
calls to and from employees at the place of employment, and request that you do not, under any
circumstances, contact my place of employment. As per the Fair Debt Collection Practices Act
(FDCPA), 15 USC 1692g Sec. 809 (a)(3), you (the debt collector) may not communicate with me (the
consumer) in connection with the collection of any debt at my place of employment if you know or
have reason to know that my employer prohibits me from receiving such communication.
Also, as per FDCPA 15 USC 1692g Sec. 809 (a)(1), I hereby notify you that it is not convenient for me
to receive communication in connection with debt collection during the hours of 8am-6pm, Monday
through Friday.
With regards,
________________
NAME