VIA CERTIFIED MAIL
Re: Wage Assignment Revocation
Our File Number:
Please be advised that this firm represents _____________ with regard to an Assignment of
Wages executed along with a combination Promissory Note and Security Agreement you now
hold. A copy of your Notice of Intent to Assign Wages is enclosed herein in order to allow you
to identify this matter. Please immediately cease any and all communication with
__________________ and direct any further correspondence to my office.
Pursuant to State and Federal regulations, this letter affirmatively revokes the Wage Assignment
previously executed by ___________________ in favor of __________________, or any
Representatives of _______________________.
Please contact ______________ employer to withdraw the assignment notice.
Very truly yours,