INSTALLMENT AGREEMENT TO PAY DEBT Date: To: Dear: This letter serves to confirm our agreement of___________, 20__, in which you acknowledge the outstanding overdue debt of $____________ to our company. We agreed that you shall make consecutive weekly payments of $___________ until the debt is satisfied in full. We further agreed that I would receive the first payment by _______________,20__ and each successive payment every ___________________ thereafter. I sincerely appreciate your cooperation in resolving this matter. Finally, would you acknowledge our agreement by signing the enclosed copy of this letter and returning it to me in the enclosed, self-addressed envelope. Very truly yours, _______________________ Form 117