Friday, May 10, 2013

letter of intent to pay debt

Here we see some examples of letter of intent to pay debt. You should modify this letter to be suitable for your purpose and situation.

Sample letter of intent to pay debt

Dear Mr. Mark,

Under our original agreement, my deadline to settle my outstanding balance of $1,600 is on June 15, 2012. Due to unforeseen circumstances concerning my health, I am unable to make payments on the said date. I would kindly like to request for a two (2) week extension to settle the matter.

In good faith, I am making a small payment of $500 today which would leave me at a balance of $1100 to your company. I am doing what ever I can to clear my debt.

Hoping for your consideration.

Sincerely,
Mrs. Sara

letter of intent to pay debt template

Date
Name
Contracts Manager
Agency/Department
Address

Re: Letter of Intent to pay for …………. services for fiscal year 2013/06
)FY 05/06(

The County of ………….Mental Health Department agrees to pay ……….. for services at ………. (agency or facility) for FY 05/06. The interim rates agreed to are as follows:

1- The FY 05/06 interim rate for Medi-Cal eligible placements is $.......... per patient day.
2-The FY 05/06 interim rate for non-Medi-Cal eligible placements is $........per patient day.

AFDC-FC payment flow between County of ……..….Mental Health Department and …….……. will be independent of this agreement.

This agreement will be in effect until a fully executed contract is in place, and reimbursement will be on a fee-for-service basis. Within 12 months following June 30, 2006, ……. will reconcile all costs with (agency……. and will provide County of …………. Mental Health with results of this reconciliation*. This reconciliation will determine actual rates and utilization by payer type for FY 05/05 and (agency or county) will either submit an additional invoice to County of ……………… Mental Health, if the rate is higher, or reimburse County of ……………………. Mental Health, if the rate is lower.

Sincerely,

Name
County Designee Authorized to Sign
______________County Mental Health

* The reconciliation will be done in accordance with ______________________________________
)Short/Doyle regulations or other appropriate reference(

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Related searches: Related searches: Example Request For Extension Letter, Intent to Pay Letter, Intent to Settle Letter template, Promissory Note for Debt Notice, Promissory Note letters,, pay outstanding debt, 

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