Notice of Acceptance of Check in Partial Payment of Balance Due

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Date (ie. July 31, 2000) BY ORDINARY MAIL Name of Debtor (Person Owing Debt) Address of Debtor Dear Sir or Madam: We acknowledge receipt of a check from you in the amount of Amount of Check being Tendered (ie. $2,000.00) toward your account relating to Describe Nature of Creation of Indebtedness (the contracting services we provided to you). We accept payment of the check without acknowledgment of any conditions or stipulations attached to the payment. We confirm that we have applied the check against the balance owing on your account which results in the amount of Amount Remaining Due and Payable (ie. $3,400.00) remaining due and payable. Please remit payment of this amount on or before Date Final Payment is Due (ie. August 31, 2000) to avoid further charges. Yours truly, Your Name

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