Your Name
Your Address
Your City, State & Zip
Today's Date
Name of Debt Collector
Address of Debt Collector
City, State & Zip of Debt Collector
Re:  Name of Company that claims you owe them money, Account #
Dear Sir/Madam:
I was notified by your company on [Date of Notice] regarding an alleged debt, as referenced above.
I deny that I owe any debt to [Company Claiming Debt] because [state in a phrase why you dispute the debt claimed].  Therefore, I am disputing the above-referenced alleged debt.  Please verify this alleged debt as required by the Fair Debt Collection Practices Act (“FDCPA”) §1692g.  
I request all of the following information be provided to me by mail:
The amount of the alleged debt
The manner in which the alleged debt was calculated, including all documents upon which it is based and which you claim establish the alleged debt and my responsibility for it;
The full name and mailing address of the original creditor for this alleged debt;
Documentation showing that you have verified that I am responsible for this alleged debt;
Documentation showing that you are licensed to collect debts in [Your State].
Because I am providing this written dispute within 30 days of being notified by your company about this alleged debt, you must cease attempting to collect this alleged debt and you may not report it to any credit reporting agency until you have provided the requested information and verified the debt.
If you continue attempting to collect on this alleged debt – or seek a judgment – without first providing written verification, you will be in violation of the FDCA.
[Your Name]