__________(2)______________

__________(3)______________

__________(4)______________

Attention: ______(5)_______

As of the date of this letter, your payment which, under the terms of a promissory note you entered into, was due on ______(6)______, has not been received and is now past due.

If you have already forwarded your payment, please disregard this letter; otherwise, please forward your payment immediately in order to avoid default under the promissory note dated _______(7)______.

Sincerely,

_____________(9)_______________