To,
___________ (Name),
___________ (Address),
___________ (Contact details)

Date: __/__/____ (date)

From,
___________ (Name),
___________ (Address),
___________ (Contact details)

Subject: Request for outstanding statement

Sir/Madam,

I would like to inform you that my name is ___________ (name) and I am writing this letter in reference to the __________ (company name) for requesting you for issuance of the outstanding payment statement from your end.

This is to request you kindly provide the outstanding statement and process my request before __/__/____ (date). I shall be highly obliged for your kind support. In this regard, do feel free to contact me at __________ (mention contact details).

Regards,
___________ (Name),
___________ (Contact details)

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