SETTLEMENT OFFER ON DISPUTED ACCOUNT
Date: _______________
To: ____________________
RE: SETTLEMENT OFFER ON DISPUTED ACCOUNT
We acknowledge your account which indicates a balance, which you claim is not due by you, in the amount of ____________________.
This alleged debt is disputed for the following reasons: _____________________________________________________________
As an offer in compromise, and without admitting liability, we offer to settle this claim in full for the sum of ____________________________. Our check in said amount is enclosed; your depositing of the check will signify your agreement, discharge the entire amount claimed, and release us from all liability thereon.
________________________________ Signature
____________________ Date