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December 9, 2011 Contact Name Address Address2 City, State/Province Zip/Postal Code

OBJECT: INSTALLMENT PAYMENT ARRANGEMENT Dear [CONTACT NAME], This is to confirm the arrangement under which we will accept payment of our outstanding account of [AMOUNT] in installments. You will sign and return the enclosed copy of this letter indicating admission of the full amount of the account and acceptance of the terms of our agreement. We will, then, accept payment of the account, together with interest at the rate of [%] per month, in consecutive, monthly installments of [AMOUNT], commencing [DATE] and continuing on the [DAY] of each successive month until paid off in full. Time will be considered to be of the essence of this arrangement. Each payment will be applied, first, to accrued interest and, second, to principal. If there is default in making any payment, at our option, the full balance owing on the account, together with accrued agreed interest, shall immediately become due and payable and continue to accrue interest, before and after judgment, at the same rate of interest until paid off in full. Please return the signed copy of this agreement with your first payment before the commencement date of the monthly installments otherwise this agreement is null and void. Sincerely,

Your name Your title (800) 123-4567 youremail@yourcompany.com Admission and Acceptance The undersigned hereby admits the full amount of the above outstanding account and having no rights of set-off or counterclaim and accepts the above terms of payment. Dated: [DATE] By: Title: _____________________ [TITLE]
Company Name Street, City, State/Province, Zip/Postal code Tel: (000) 000-0000 / Fax: (000) 000-0000 www.yourwebsite.com

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