FORMAL DEBT COLLECTION & OVERDUE PAYMENT DEMAND LETTER
================================================================

Effective Date: ________________________________________________________
Place: _________________________________________________________________

================================================================

1. Parties
----------

This document is made on ____________________ (____________________) by:

Creditor
Individual
Full Legal Name: _______________________________________________________
SSN / ID: ______________________________________________________________
Doc Series: ____________________________________________________________
Address: _______________________________________________________________
         _______________________________________________________________

Addressed to:

Debtor
Individual
Full Legal Name: _______________________________________________________
SSN / ID: ______________________________________________________________
Doc Series: ____________________________________________________________
Address: _______________________________________________________________
         _______________________________________________________________

2. SUBJECT-MATTER SCHEDULE & SPECIFICATIONS
-------------------------------------------

Original Debt / Invoice Reference:
    ____________________________________________________________________
Date Payment Was Due: __________________________________________________
Outstanding Amount: ____________________________________________________
Payment Deadline: ______________________________________________________
Payment Instructions: __________________________________________________

3. EXECUTION & SIGNATURES
-------------------------

Creditor

Signature: _____________________________________________________________

Full Legal Name: _______________________________________________________
Date: __________________________________________________________________