NOTICE OF PAYMENT
(An Act respecting the collection of certain debts (chapter R-2.2, s. 34)
______________________________
(number of holder’s permit)
Date: ______________________________________________________________________________
(date on which notice of payment is sent)
Place: _____________________________________________________________________________
(place from which notice of payment is sent)
(name of permit holder)
(address of permit holder)
___________________________________
(name of debtor)
___________________________________
(address of debtor)
(name of creditor of debt to be collected)
(amount of debt to be collected)
(Text of the notice of payment) _________________________________________________________
It is in the debtor’s interest to become familiar with the Act respecting the collection of certain debts and, where necessary, to communicate with the Office de la protection du consommateur.