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Waiver Letter (Free Samples)

Use these sample waiver letters as templates for your formal waiver letter.
​Last updated on September 19th, 2021


​Sample 1 - 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

​Sample 2 - 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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