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

We assume it is simply an oversight when the account of a good customer such as yourself falls behind.

We now request your immediate payment on the overdue balance of $___.

Thank you for your prompt attention and your continued patronage.