1001 West Main St
Anywhere, OR 44444
Re: Collection for Account #: 00000xxxx
I was a patient at the Main Street Clinic in 2007, and was very happy with my doctor. Unfortunately, due to a major upheaval in my life, I was not responsive in paying the amount that I owed. For this I apologize, and I intend to make amends.
If it is possible, however, I respectfully request that you attempt to submit the original bill to my insurance carrier at the time. I have included a copy of my insurance card. If I recall, I did not have provided my insurance information at the time of treatment, and was negligent in following up on the matter. I would consider it a great courtesy if you could attempt to do so at this time.
However, if this is not successful, I am willing to pay this account for 100% of the amount shown on my credit report pulled March 11, 2008 if you agree to immediate remove this debt from the Collection Agency, and also have Small Town Collection Agency, LLC delete this account from any and all credit reporting agencies (Equifax, Experian and TransUnion).
If you agree to the terms and accept this agreement, certified funds for the full amount of twenty-five dollars ($423.00) will be sent to Doctor’s Clinic in exchange for full deletion of ALL references regarding this account from my credit files and full satisfaction of the debt.
Doctor’s Clinic agrees to remove this debt from Small Town Collection Agency, LLC, and also have Small Town Collection Agency, LLC, delete ALL information regarding this account from the credit reporting agencies within twenty-one calendar (21) days following receipt of payment as specified above.
If you agree to the above terms, please prepare a letter on your company letterhead explicitly agreeing to the same terms as the above settlement offer and have it signed by an authorized representative of Doctor’s Clinic. It will be implied that this letter shall constitute a legally binding contract, enforceable under the laws of the state of Oregon.
Thank you for your consideration.
Please address all correspondence regarding this account to:
123 Any Street
City, Not Oregon