[Date]

[Addressee]

Dear [Name]:

On [date] we called your attention to your account balance 
in the amount of $ [dollar amount].

According to our records, we have not received either a 
reply to our letter nor a remittance to clear this account. 
We extended credit to you on your account in good faith 
and expected payment under our normal thirty-day terms, 
which we feel are most reasonable. 

So that no further action on our part will be necessary, we 
shall expect a remittance by return mail or the courtesy of 
a reply to our letter as to why payment is being withheld. 

Very truly yours,