No-Contact Letter, Verification Request Form Page 4

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TO:____________________________
By Certified Mail RRR
_______________________________
#_________________
_______________________________
_______________________________
RE: ACCOUNT #_________________________
Dear Sir or Madam:
I am writing to request that you stop communications to me regarding my account. The Fair Debt Collection
Practices Act, 15 U.S.C. §1692 et seq., requires that you honor my request.
Under the Fair Debt Collection Practices Act, once I have asked you to stop contacting me you may only
communicate with me to (1) advise me that your further efforts are being terminated, (2) notify me that you
may invoke specified remedies that you normally invoke or (3) where applicable, to notify me that you intend
to invoke a specified remedy.
Until advised otherwise, you should consider this debt to be disputed.
Furthermore, I have been the victim of abusive collection practices by agents of your company.
Specifically:
.
You should know that such practices violate Federal law and place you in jeopardy of legal
liability.
I also wish to inform you that my sole source of income is Supplemental Security Income (SSI)/
Social Security. As a result, my income is exempt from garnishment for this type of debt. I have
no non-exempt assets.
Thank you for your cooperation.
Sincerely,
________________________
Dated:
__________________________ (print name)
(street address)
(city, state & zip)

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