This Agreement to Settle Disputed Account is a formal agreement to settle a disputed account. This agreement is between a seller of goods or services and a customer who has disputed the amount due for those items. It sets out the names of seller and customer, amount due and the amount which the seller will accept as payment on the disputed account. It is imperative that this agreement be clearly set out in writing. A written Agreement to Settle Disputed Account will prove useful in the event the customer does not pay the agreed upon amount in the timeframe given by the seller.

This Agreement to Settle Disputed Account includes:

• Parties: Sets forth the name of the seller and customer who disputes the amount due on an account;
• Account Information: Amount due on the account and detailed information regarding the invoices on which this amount is based;
• Payment: The payment which the seller will accept and the timeframe in which the customer has to make this account payment;
• Signature: This agreement must be signed by both parties.

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This attorney-prepared packet contains:

1. General Instructions
2. Agreement to Settle Disputed Account

State Law Compliance: This form complies with the laws of all states