Payment Plan Agreement Letter PDF

Outline repayment terms for debts, rent arrears, or medical bills with balance, installment amount, start date, and late policy. Download the PDF and share it for signatures.

For negotiation and documentation only. Not legal advice.

Payment plan agreement letter

Lay out balance, payment amounts, frequency, and late policy so both parties can sign and keep the same terms.

Creditor

Debtor

Account / case # (optional)

Total balance

Payment amount

Payment frequency

First payment date

Payment method

Where to send payment

Late policy

Notes (optional)

Creditor printed name

Debtor printed name

Signature date

Share this with the other party to sign and attach to your bundle.

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Review details before sending; nothing here is legal advice or a substitute for local forms.