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Fillable Form Debt Validation Letter

Debt Validation Letter is used for verification of a debt and other related information. This letter must be sent within thirty (30) days of receiving notice of the attempt to collect.


What is a Debt Validation Letter?

A Debt Validation Letter is a letter that an individual sends to their creditor or collection agency requesting proof that the debt in question is valid and not outside the statute of limitations for collecting the debt.

The Federal Fair Debt Collections Practices Act (FDCPA) or state legislation defines the statute of limitations for recovering a debt. If the debt exceeds the timeframe which should be included in the certification letter, it is no longer possible to undertake collection efforts.

Who writes a Debt Validation Letter?

A Debt Validation Letter is usually written when a debtor wants to verify that the loan they are paying is completely legal and that the Debt is truly yours to settle.

How to fill out a Debt Validation Letter?

A Debt Validation Letter requires you to read and understand the provided information before filling out the letter.

Page 1


Enter your full name.


Enter your address.

City, state, and ZIP

Enter the city, state, and ZIP code of your address.


Enter the date when the letter is being filled out.

The person you are sending the letter to

Enter the name of the person or the office you are addressing the letter to.

Letter is being sent in response to:

Mark the first box if you are responding to a notice sent to you at a specified date, enter the date. Mark the second box if you are responding to a listing on your Credit Report.

Content of the letter

The first part of the body of the letter states that you are not refusing to pay and you are only sending a notice as stated in the Fair Debt Collection Practices Act, 15 USC 1692g that the claim is disputed and therefore you are requesting validation.

The letter is not a request for “verification” but rather a request for validation made pursuant to the provided title and section. You are also requesting evidence that you have a legal obligation.

You are also informing the receiver that if they have reported any false or invalidated information to any of the three major credit bureaus namely Equifax, Experian, or TransUnion, this action may result in fraud under both Federal and State Laws. If there is any negative mark that you see in your credit reports, do not hesitate to execute a legal action against the offices that committed these violations under the following: Violation of the Fair Credit Reporting Act, Violation of the Fair Debt Collection Practices Act, and Defamation of Character.

If the office is able to provide you with the requested documentation, you may require at least 30 days to review the information you are given. During that time, all collection that you are involved in must cease and desist. Also in that period, if any action is done that is considered detrimental to any of your credit reports, you may consult with your legal counsel for a lawsuit.

If your letter is not responded to by the recipient within 30 days, all the references to your account must be erased and completely removed from your credit information and a copy of such deletion request must be given to you immediately.


Provide your signature.

Page 2


In this part of the letter, you are requesting that no telephone contact shall be made to your home or place of employment. If their offices continue to attempt to contact you it will be considered harassment and you may choose to file a lawsuit. You are also stating that any future communications with you MUST be in writing and sent to the address that you entered in the letter. You are also advising the offices and their client to assure that their records are in order before you are forced to take legal actions.


Provide your signature.

Page 3


Name and Address of Alleged Creditor

Enter the full name and address of the alleged creditor.

Name on File of the Alleged Debtor

Enter the name of the Alleged Debtor on the file.

Alleged Account number

Enter the alleged account number of the debtor.

Address on File for Alleged Debtor

Enter the address of the alleged debtor on the file.

Amount of the Alleged Debt

Enter the amount of the alleged debt.

The date that this alleged debt became payable

Enter the date when the alleged debt became payable.

Date of Original Charge or Delinquency

Enter the date of the original charge or delinquency.

Was this debt assigned to a Debt Collector or Purchased?

Enter whether the debt was assigned to a debt collector or if it was purchased.

Amount Paid if Debt was Purchased

Enter the amount paid if the debt was purchased.

Commission for debt collector if collection efforts are successful

Enter the amount of commission the debt collector earns if the collection efforts are successful.

Page 4


This section requires you to attach the copies of the following:

  • Agreement with the client that grants a collection agency the authority to collect the debt. Enter the name of the collection agency.
  • Provide the signed agreement that the Debtor has made with the Debt collector, or other confirmable proof that Debtor has contractual obligation to pay Debt Collector
  • Provide any agreement or written document that shows the signature of the Debtor, wherein the Debtor agrees to pay the Creditor.
  • All the statements while the account was open.

Are there any insurance claims that were made by any creditor regarding this account?

Mark Yes if there were any insurance claims made. Mark No if there were not any insurance claims made regarding your account.

Are there any judgments obtained by any creditor regarding this account?

Mark Yes if there are any judgments obtained. Mark No if there are no judgments obtained by any creditor regarding this account.

Bonding Agent of Debt Collector

Enter the name and address of the bonding agent of the debt collector in case legal actions become necessary. Enter the name of the Debt Collector in the field provided.

Signature of Creditor

The creditor must provide a signature.

In this section, you are requiring the office to complete this form along with copies of the information you have requested, which will initiate the right to collect the alleged debt from you within 30 days from the date of the receiving of this letter.

The collection will not be considered if any part of this form is not completed and if you are not provided with the requested documents.

You have at least 30 days to process this information.

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