Hardship Letter to Creditors Template

Date: [Date]

To: [Creditor Name]
Address: [Creditor Address]
Re: Hardship Request for Account #[Account Number] (or Reference #[Reference])

1. Account and Contact Information

1.1 Account Holder Name: [Full Name]
1.2 Phone/Email: [Phone] / [Email]
1.3 Mailing Address: [Address]

2. Purpose of This Letter

2.1 I am writing to explain my current financial hardship and request assistance with my account listed above.
2.2 I want to resolve this matter in good faith and avoid further delinquency if possible.

3. Hardship Explanation

3.1 Reason for Hardship: ☐ Job loss ☐ Reduced hours ☐ Medical expenses ☐ Family emergency ☐ Divorce/separation ☐ Other: [Explain]
3.2 When It Began: [Month/Year].
3.3 Status: ☐ Temporary ☐ Long-term.
3.4 Brief Details (Plain Language):
[2–5 sentences explaining what happened and how it affected your income/expenses.]

4. Requested Assistance

4.1 I am requesting the following assistance (select one or more):
☐ Temporary payment reduction to $[Amount] for [] months
☐ Payment deferral/forbearance until [Date]
☐ Interest rate reduction to []%
☐ Waiver of late fees/penalties (from [Date] to [Date])
☐ A payment plan: $[Amount] per month for [__] months
☐ Settlement offer: I can pay $[Amount] as a lump sum by [Date] to settle the account in full
☐ Other: [Request]

4.2 If you approve a plan, please confirm the terms in writing and provide instructions for payment.

5. What I Can Afford

5.1 Based on my current budget, I can afford: $[Amount] per ☐ month ☐ pay period.
5.2 I expect my financial situation may improve by: [Date/estimate], if applicable.

6. Supporting Documents (Optional)

6.1 I can provide documents supporting my hardship, such as:

• Proof of income reduction or termination

• Recent pay stubs or benefit statements

• Medical bills (summary pages)

• Bank statements (summary pages)

• Monthly budget summary

• Other: [List]

7. Preferred Contact and Next Steps

7.1 You can reach me at [Phone] or [Email].
7.2 I appreciate your consideration and look forward to resolving this account.

Sincerely,
[Your Full Name]

Signatures

Signature: ___________________________
Date: [Date]