As you can see, the bank letter example above has all of the required components (date, name of bank, account name, account number, routing number). Name of Customer Being Debited: 6.Account Number of Customer Being Debited: 7. We currently require a verified customer signature prior to completing a change of address, either in person or received in the mail. You must request the hearing in writing. The signer must sign the document in the presence of the notary public. In the sample letter, fill in your personal information. Keep a record of who you spoke with and when — then follow up with a letter like the sample below. "Explore our form designed to confirm income and employment history of previous or current employees.