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How to Write a Simple Waiver Letter (with Samples)

Use these sample waiver letters as templates for your formal waiver letter.
​Last updated on January 15th, 2019

Waiver Letter (Free Samples)
A waiver letter is a formal written request for the party receiving the letter to forego a certain restriction that would otherwise be put into effect, such as a financial obligation, contract, or a citation. However, writing a letter of waiver isn't a 100 percent guarantee that the other party will comply.
​
​Here's how to construct a formal letter of waiver along with some sample letters to help guide you.Any entity that issues any kind of obligation contains certain terms of eligibility that has to be fully considered when dealing with a waiver request. Before you sit down and write your letter make sure you completely understand those specific terms in order to determine if you qualify or not.

​Waiver Request Letter Samples
  • ​Waiver Letter for Bank Charges
  • Waiver Letter for Payment​
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Clearly Explain Your Request

​Start the letter off with a clear explanation regarding your request. For instance, explain that you're requesting certain fees or charges to be waived or to be released from a previous engagement. Communicate any supporting or relative dates, names of parties, monetary figures, or venues as facts. Don't attempt to exaggerate the significance of your assertions or statement.
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​​​​Send your letter of waiver along with any contract copies, receipts, photos, or email printouts that can corroborate your statement. There are a number of reasons why someone may need to write a waiver letter. Here are a few examples to guide you.

Waiver Letter for Bank Charges 
Customer’s Name
Customer’s Address
City, State, Zip Code

DATE

Name of Bank Manager
Title
Name of Bank
Bank Address
City, State, Zip Code

RE: Checking Account 5123144552

To Name of Bank Manager,

I want to formally request that you seriously consider reimbursing some bank fees that you applied to an unexpected overdraft that's unfortunately been accruing since the beginning of the year. The mere fact that I let my account get into the red is proof of my severe financial hardship.

Therefore, continuing to charge me for more direct debits that I failed to cancel in time along with the overdraft interest fees, has only compounded the issue and made it even more difficult to get it paid-in-full. At this point, I can hardly afford to keep food on the table for my children.

I can get my account back into the positive and pay down the debt if the fees of $400 are waived. If they aren't, I will have no other choice than to seek legal counsel.

Thank you for your consideration and I eagerly wait for your reply.

Sincerely,

Customer’s Signature
Printed Customer’s Name


​Waiver Letter for Payment
Name of Sender
Address of Sender
City, State, Zip Code

DATE

RE: Bank or Loan Account Number

To Whom It May Concern:

This letter is a formal request to have my monthly payments of $150 on my car loan frozen and have all late fees waived for six months from DATE to DATE. I am currently in financial difficulty because of an injury I received in a car accident through no fault of mine. Since I work for minimum wage, I have no resources to maintain my payments. 

I will be undergoing physical therapy for the next four months and hope to be able to find a job after that. I have met my loan obligation regularly for the past one year and have every intention of paying it off. 

I have enclosed my medical report and doctor’s letter as proof of my condition. If you have any questions, I can be reached at Phone Number or at Email Address. 

Thank you for considering my request.

Sincerely,
​

Signature of Sender
Printed Name of Sender
List of Enclosures: Medical Reports

​​By Andre Bradley

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