[Your Name]

[Street Address]

[City, ST ZIP Code]

[Date]

[Recipient Name]

[Title]

[Company Name]

[Street Address]

[City, ST ZIP Code]

Dear [Recipient Name]:

Due to unforeseen circumstances, we are unable to make our payment on time this month. We expect these circumstances to be resolved within [number] of days, at which time we assure you that we will immediately remit payment in the amount of $[amount]. Our account number is [account number]. If you have questions, please contact me at [phone number].

Sincerely,

[Your Name]

[Title]

Enclosure