Date: ____________________

_______________________________
_______________________________
_______________________________

Attn: Customer Service

Name(s) on account: ____________________
Account number: ____________________

To Whom It May Concern:

At the present, I cannot pay the monthly amount required under the agreement for the following reason(s):
________________________________________________________________________

Due to my desperate financial situation, I cannot make any payments for the indefinite future. _____[Describe hardship]_____.

I promise to inform you immediately if my financial condition improves and I am able to resume making normal payments. 

Thank you for your understanding and help. Please write within 20 days to let me know if this is unacceptable.

Sincerely,

________________________________________
	Your signature

Name:	____________________
Address:	____________________
____________________
Home phone:	____________________
Email address:	____________________