UCS124 DMDLTR

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Commercial Claim Arising Out of a Consumer Transaction

DEMAND LETTER

To: _____________________________ Date:


Name of Defendant
_____________________________

_____________________________
Address

You have not paid a debt owed _____________________________________________,


which you incurred on ________________________________________, 20____. The amount
remaining unpaid on this debt is $_____________________________. Demand is hereby made
that this money be paid. Unless payment of this amount is received by the undersigned no later
than _____________________________, 20___, a lawsuit will be brought against you in the
Commercial Claims Part of the Court.

If a lawsuit is brought, you will be notified of the hearing date, and you will be entitled to
appear at the hearing and present any defense you may have to this claim.

(If applicable) Our records show that you have made the following payment in partial
satisfaction of this debt (fill in dates and amounts paid) _______________________________.

A copy of the original debt instrument — your agreement to pay — is attached.


[The names and addresses of the parties to that original debt instrument are:

_____________________________________________________________________________

______________________________________________________________________________

____________________________________________________________________________

(to be completed if claimant was not a party to the original transaction)].

_________________________________________

_________________________________________

_________________________________________
Typed or Printed Name and Address of Claimant
UCS-124 (Rev. 8/08)

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