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Agreement for Payment (with Sample)
Use this sample agreement for payment letter as a template for your formal agreement letter.
​Last updated on February 12th, 2019


​Sample Payment Agreement Letter


FULL NAME OF PAYEE
FULL NAME OF PROMISOR
DATE OF LOAN
DATE REPAYMENT IS DUE
TOTAL AMOUNT DUE

TERMS OF AGREEMENT:

I, FULL NAME, borrowed $500 from FULL NAME on DATE. We both agreed that the money would be repaid in a series of scheduled payments. 

I, FULL NAME, will repay the loan with a personal check in a series of $100 payments every month for five months starting DATE. The payments will be given to FULL NAME on the first of every month beginning with June 1st with the last payment being made on October 1st.

I, FULL NAME, will pay a $5 per day late charge for any payments that are not on time as agreed until the loan is paid in full. 

The payee and the promisor agree to the payment agreement terms listed above.

Signed:

Signature of Promisor DATE
Printed full name and address, email address, phone number of promisor

Signature of Payee DATE
Printed full name and address, email address, phone number of payee

Signature of Witness(s) DATE
Printed full name and address, email address, phone number of witness(s)

Example of letter body with lump sum payment:

I, FULL NAME, borrowed $500 from FULL NAME on DATE. The money is to be repaid in one lump sum. I, FULL NAME, promise to repay the full amount, $500, with a personal check on DATE. I agree to pay a late fee of $5 per day until the loan is paid in full if I am not able to make the payment on the agreed date.

The payee and the promisor agree to the payment agreement terms listed above.

By Andre Bradley

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