Financial Hardship Letter Template - Sample

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(Company's representative)
(Company's Name)
(Company's Address)
(Company's phone number)
RE: (Home Address)
Account Number:(#)
Dear (Ms/Mr. Brown:)
I/We, (Your Name),
are/am requesting that you review my/our financial state of affairs to see if I/we qualify for a
loan workout option.
I/We are having problems making my/our monthly payments because of financial troubles
created by (pick one):
Death of my spouse
Divorce
Job layoff
Separation
Medical bills
Too much debt
Unemployment
Death of a family member
Business failure
Loss of income
Job relocation
Illness
Damage to property
Military service
Payment increase
Incarceration
Other (Please Specify)__________________
This difficulty or situation happened on or about this date MM/DD/YYYY.
I/We believe that my/our situation is (circle one) Temporary / Permanent
The following is a brief account of my/our situation: (explain your situation and tell them why
you feel you can now afford your new payments/payments)

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