Cease & Desist Letter (United States) Form

Type of Cease and Desist

Type:

Debt Collection

Your Information

Full Name:

Corporation/Individual:

IndividualCorporation

Representative's Name:

Apartment:

Street Address:

City:

State:

Alabama

ZIP Code:

Recipient's Information

Full Name:

Corporation/Individual:

IndividualCorporation

Representative's Name:

Apartment:

Street Address:

City:

State:

Alabama

ZIP Code:

Debt Information

Your Account Number:

Do you want to provide notice that you will file suit against the collection agency if it does not stop calling you?	YesNo
Do you want to provide notice that you will file a formal complaint with the Federal Trade Commission (which is responsible for the enforcement of the FDCPA) and the Attorney General of your state if the collection agency does not comply with your letter?	YesNo
Do you want to provide notice that you intend to record telephone conversations?	YesNo
Do you want to provide notice that you intend to file suit against the collection agency if any negative information is placed on your credit reports?	YesNo
Do you want to provide notice that you intend to keep a log of any contacts the collection agency makes with you after they receive this letter?	YesNo
If your employer prohibits calls from collection agencies, do you wish to demand that the collection agency not contact you at your place of employment?	YesNo

Debt Information

Reference/Account Number:

Debt is in dispute?

YesNo

A collection agent can no longer communicate with you or proceed with any collection activities if you have sent a letter by registered mail to the creditor (and collection agent) that the debt or the amount of the debt is in dispute and you wish the creditor to take the matter to court.

Collection Agency only allowed to communicate with you:

No restriction

Address for communication:

(e.g. 4565-90 Street N.W., Toronto, ON M3R 2T4)

Name of legal advisor:

Address for legal advisor:

(e.g. 4565-90 Street N.W., Toronto, ON M3R 2T4)

Do you want to provide notice that you intend to keep a log of any contacts the collection agency makes with you after they receive this letter?

YesNo

If your employer prohibits calls from collection agencies, do you wish to demand that the collection agency not contact you at your place of employment?

YesNo

Debt Collection Details

Type of response:

You are not the debtor/know nothing of debt

If you know nothing of the debt or are not the debtor, you can tell the Debt Collection Agency (DCA) to stop bothering you.

Reference/Account No:

Letter is being sent to:

Original Creditor

Name of Original Creditor:

Type of Credit Agreement:

Fixed Loan Amount (s.77 request)

Letter Delivery Date:

If it was sent "recorded delivery", it was delivered the day they sign for it. If the letter/request was sent by first class mail, then it is deemed to be delivered 2 working days after the date the letter was posted. If the letter/request is sent by second class mail, it is deemed to be delivered 4 working days after it was send. You don't include the day the it was posted. Working days are Monday to Friday, excluding bank holidays.

When time to answer Request expired:

You must add 12 working days to the delivery date above. Working days are Monday to Friday, excluding bank holidays.

Letter Options

Describe what you want stopped including examples and the reason why it should stop:

Note: This will be a full paragraph that appears on its own in the letter.

Do you want to provide notice that you will file suit against the recipient if they do not comply with this letter?

YesNo

Do you want to provide notice that you intend to record telephone conversations?

YesNo

Do you want to provide notice that you intend to keep a log of any contacts the recipient of this letter makes with you after they receive this letter?

YesNo

Infringement Information

Name of Infringing Work:

Name of Your Work:

Year Your Original Work was Published:

Where Your Original Work Was Published:

Website

Website Address:

(e.g. www.yourwebsite.com)

Give a few examples that illustrate direct copying and/or unfair use:

Note: this will appear as its own full paragraph within the letter.

Date by which you wish to receive a response from infringing party:

Two weeks from date of letter

Specify Date:

Date

Date of this letter:

Today

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Type of Cease and Desist

Your Information

Recipient's Information

Debt Information

Debt Information

Debt Collection Details

Letter Options

Infringement Information

Date