To fill out this letter, clearly write your name and address at the top. Include the date and the collection agency's name and address.Below is a sample, fillintheblank letter that you can use as a guide for disputing a debt with a collector. Learn how to write an effective collection dispute letter with our guide and templates. How to use this sample letter: 1. Read the background below. 2. Want to settle your debt? A debt settlement letter is all you need to negotiate debts with your creditors. It asks you to pay a certain settlement amount to the collection agency. As of September 30, 2024, grantees have provided legal assistance to over 44,000 households, representing a rapid scale-up to meet tenant needs.