Creditor, Objection to Debtor Offset

Date:

Name of Debtor (Person Owing Debt)
Address:

Dear Sir or Madam:

We acknowledge receipt of your check tendered in the amount of $_________, which we accept as payment against your overdue balance of $___________, without acknowledging any of the conditions attached to your payment.

Please remit the balance of $ ___________ prior to __________ (Date) to avoid further charges.

Yours very truly,

___________________________
Authorized Employee or Individual