Dear …

RE: __(Name – Reference #)__

With reference to our recent discussion, we have reviewed your account and have now made a few credit adjustments, arriving at a final payout in the amount of __($amount)__. Outlined below is a summary of the __(recent transactions/account transaction history)__ on your account with __(name of organization)__. You will note that we have written off __(type of charges/fees)__ as agreed.

Date Description $ Amount

__(Date)__ (Transaction description or payment) (dollar amount)

__(Date)__ (Transaction description or payment) (dollar amount)

__(Date)__ (Transaction description or payment) (dollar amount)

__(Date)__ (Transaction description or payment) (dollar amount)

_________ Balance Due $ amount_

We look forward to receiving your final payment and no doubt you are happy to be making this last payment. Thank you for allowing us the opportunity to have provided you with __(type of service/product)__. If we can be of assistance to your with future __(type of needs)__ requirements, please don’t hesitate to contact us.

Yours truly,