An agreement can be reached before you come to court or when you are in court. Please include in your letter or e-mail, your name, address, e-mail address and phone number so that we may properly respond to your inquiry in writing.The written confirmation of the debt payment schedule or settlement agreement with a consumer that a debt collection agency is required to furnish. A notice of claim must be filed in writing. Sample Confirmation Letter Used In Injury Settlement Negotiations. If submitting online, you must provide your Social Security number for verification. A letter application form that must be completed, served on all other parties and submitted with Proof of Service via EDDS. XYZ Corporation New York, NY 12345. Get this from the Small Claims Clerk in your district.