Demand for payment

DEMAND FOR PAYMENT

Date:____________________

TO: ____________________

Your account is delinquent in the amount of ____________________ AZN.

Please be advised that in the event we do not receive payment in full within ______ days of the date of this notice, we will initiate collection proceedings against you without further notice. If such proceedings are initiated, you will also be responsible for pre-judgment interest, attorneys’ fees, court costs, and any and all other costs of collection. Collection proceedings may also adversely affect your credit rating.

If full payment has already been sent, please disregard this notice.

Please contact the undersigned if you have any questions.