[Your name]
[Your mailing address]
[Today's date]
[Collection agency name]
[Collection agency address]
Re: Account [Reference number on their letter]. Original creditor named in your notice: [Hospital or doctor named].
To whom it may concern:
I am writing about the account referenced above. I dispute this debt and request validation. Please send me:
- the name and address of the original creditor;
- the amount you say is owed, and how it was calculated, including any interest or fees;
- an itemized statement from the original provider for the services billed;
- a copy of any agreement that gives you the right to collect this account.
Please stop collection activity on this account until you have sent this information. Please do not report this account to a credit bureau while it is in dispute.
This letter is not an acknowledgment that I owe this debt. Please communicate with me in writing only, at the address above.
[Your name]