[Your Name]
[Street Address]
[City, State ZIP Code]
[phone number – optional]
[email address – optional]
May 19, 2009
[Name of Recipient]
[Title]
[Company Name]
[Street Address]
[City, State ZIP Code]
Dear [Name of Recipient]:
Re: [Bankruptcy Case No.]
I am a creditor of [Name of Business or Individual], who, I understand, has initiated bankruptcy proceedings under the above-referenced case number.
I wish to request inclusion in the list of creditors in this case, so that [Name of Business or Individual]’s account with me may be considered for payment as the bankruptcy process goes forward.
The total amount owed to me by [Name of Business or Individual] is [$___].
Please let me know what further steps, if any, I must take to ensure that my request for inclusion on the list is considered; if there are any forms to be filled out, please send them to me at the address on the letterhead above.
Thank you in advance for your assistance in this matter.
Cordially,
[Your Name]
Enclosures