This attorney drafted form letter sets forth a written notice from a consumer to a credit
providing agency (for example a credit card company) to cancel his or her revolving
credit account, and to ensure same is reported to the credit reporting agencies. This
letter can be customized to fit the needs of the individual and can also be used to cancel
other types of accounts, subscriptions and memberships.
[Instruction: Insert personal letterhead.]
_____ [Instruction: Insert date.]
_____ [Instruction: Insert addressee.]
_____ [Instruction: Insert addressee address.]
_____ [Instruction: Insert addressee city, state, zip code.]
Re: Closing account on _____ [Instruction: Insert card name to
be closed.], account _____ [Instruction: Insert account number of
Dear Sir or Madam:
This letter shall serve as my written notice and authorization to close the above-referenced
account as of _____ [Instruction: Insert date card closing should become effective.], after
which date, no further activity should be permitted, including by any additional cardholders or
authorized signatories for the account, if any. For clarity, the cardholder information for the
account is as follows: _____ [Instruction: Insert pertinent card information, including
cardholder and account billing address.].
I paid the account's balance in full on _____ [Instruction: Insert date.]. I have received
confirmation from my bank that this payment was received on ____ [Instruction: Insert
payment posting date. If a copy of the cancelled check or verification of payment can be
provided, include a statement that such confirmation is being included in the letter, and
enclose a copy of such proof of payment.] Enclosed herein are any and all credit cards issued
to me with respect to this account, including any issued to any additional cardholders or
authorized signatories, if any, which have been destroyed for security purposes.
To my knowledge, upon your receipt of this letter, all responsibilities with respect to this credit
card account have been fulfilled pursuant to applicable law and the cardholder agreement.
Therefore, please close my account and include a notation in any report to a credit bureau that
the account was "closed by request of cardholder."
Please send me written confirmation of the closure of my account, in good standing and at my
If there are any discrepancies between my records and yours, please contact me by mail at the
address below or by phone at _____ [Instruction: Insert phone number.].
Thank you for your prompt attention to this matter.
[Instruction: Insert signature block.]
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