SETTLEMENT OFFER Date: To: RE: SETTLEMENT OFFER ON DISPUTED ACCOUNT Sirs: We acknowledge your bills indicating a balance you claim to be due you in the amount of $ _________. This alleged debt is disputed for the following reasons: As an offer in compromise, and without admitting liability, we offer to settle this claim in full for the sum of $___________. Our check in said amount is enclosed and your depositing of the check will signify your agreement and will discharge the entire amount claimed and release us from all liability thereon. Very truly yours, ___________________________ Form 111