New York City residents can use this letter to dispute a debt, to verify a debt under NYC law, and to tell a collector to stop contacting them. Enter the date, applicant and beneficiary information.Agreement with your client that grants you the authority to collect on this alleged debt. 1. In the sample letter, fill in your personal information. Remember to include copies of all documentation along with your letter before you send it in the mail. Letter of Explanation Sample. Use this sample letter to dispute incorrect or inaccurate information that a business supplied to credit bureaus. Refer to the examples, below, for guidance when completing, revoking, or withdrawing Form POA1, Power of Attorney. Intheblanks form authorizing a filing agent to efile documents on behalf of an individual attorney. Because chargeback windows can vary, we suggest storing all signed authorization forms for up to two to three months after you stop charging the card on file.