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Date
Bill Collector Name and Address
RE: [Name of Creditor] Account No. [ ]
Dear Sir or Madam:
I am writing to request that you stop all contact with me regarding the above account as required by the Fair Debt Collection Practices Act, 15 USC sec. 1692c(c).
I am unable to pay the debt at this time.
Sincerely,
Your Signature
[Your Name and Address]