[YOUR NAME]
[YOUR ADDRESS: LINE 1]
[ADDRESS: LINE 2]
[ADDRESS: TOWN]
[ADDRESS: COUNTY]
[ADDRESS: POST CODE]
[YOUR TELEPHONE NUMBER]
[DATE]
[NAME OF CREDITOR]
[ADDRESS OF CREDITOR: LINE 1]
[ADDRESS: LINE 2]
[ADDRESS: TOWN]
[ADDRESS: COUNTY]
[ADDRESS: POST CODE]
Ref. Account number/Agreement Number: [YOUR ACCOUNT/AGREEMENT NUMBER]
Dear Sirs,
I am currently experiencing financial difficulties as a result of [SELECT FROM: disability / serious illness / a loss of employment / a relationship breakdown / imprisonment / starting work in a lower paid job / starting full-time education / needing to take parental care leave / etc.] and I am therefore unable to keep up with the full payments due on my account.
I am trying to resolve my current situation and will be sending you a financial statement as soon as possible along with an offer of the best payment I can manage in light of my circumstances.
Please can you provide me with the following information? This will allow me to formulate a schedule of all my debts and make appropriate offers to my creditors:
I will contact you again, in writing, as soon as I have received replies from each of my creditors.
Yours faithfully
[SIGN HERE]
[PRINT NAME HERE]
Enclosures: [STATE DOCUMENTS YOU HAVE ENCLOSED, IF ANY]