RESTRICTIVE ENDORSEMENT NOTICE
(Attach check to this A&S after sending 15-day letter)
Certified Mail # (Enter Number)
(Your Full Name)
(Street Address),
(City, State & Zip)
(Name of Creditor)
(Address)
(City, State & Zip)
Date:
Account Number(s):
To Whom It May Concern,
This attached letter is to confirm that you have accepted, based on your non-objection to a 15-
day restrictive endorsement notice, an offer of Accord & Satisfaction concerning the above noted
account. Upon endorsement of the attached payment instrument, you hereby agree to the
following terms:
The check attached in the amount of $(Enter Amount), represents full and final payment; and,
You, upon endorsement and deposit of said lump sum payment, and upon commencement of
bank clearance of funds from such payment, agree to delete any negative items being reported to
the 3 major credit bureaus within 30 days; and mail me written notice of such deletion; and,
You, upon receipt of lump sum payment, agrees to report a new account to all 3 major credit
bureaus as PAID AS AGREED, with no late-payments or derogatory comments whatsoever,
within 30 days; and,
And, last but not least, you also hereby agree to cease all collection or legal activity on said
extinguished account.
Sincerely,
Signature