Creditor: ______________________________

Address: ______________________________

City, St. Zip: ____________________________

NOTICE TO CREDITORS
FAIR DEBT COLLECTION ACT

Re: Acct # __________________________________________________

Dear Creditor:

Pursuant to the Fair Debt Collection Act 15 U.S.C., Section 1692 , this is to request that you stop CALLING ME, MY FAMILY OR MY PLACE OF EMPLOYMENT as required by the Fair Debt Collection Act. Please direct all further correcpondence by U.S. Mail ONLY to my address: _______________________________________.

This letter is not meant in any way to be an acknowledgement that I owe this money.

Your cooperation will be appreciated.

Sincerely,

__________________________________
Print Name

__________________________________
Signature