YOUR COMPANY NAME
YOUR COMPANY STREET ADDRESS
YOUR COMPANY CITY, STATE, ZIP
YOUR COMPANY PHONE AND FAX NUMBER

TODAY'S DATE

RECIPIENT'S COMPANY
ATTN: RECIPIENT'S NAME
RECIPIENT'S STREET ADDRESS
RECIPIENT'S CITY, STATE, ZIP

On DATE, you promised to pay your overdue balance in (weekly/monthly) payments of $___ each.

We have not received your payment due on DATE.  We assume this was simply an oversight, and you shall immediately remit your payment.

Please give this matter your immediate attention so we know you intend to comply with your agreed payment terms.