My name is {Name} and I reside at {address}. I am writing because {Utility Company} is planning to suspend the {gas/electricity/water/etc.} at my residence due to lack of payment. I am requesting leniency due to severe financial hardship, and because a member of the household is extremely ill and requires utilities.
I am currently unable to pay the utilities' fee due to {reason}. I am attaching proof of income, bills, receipts, and other payments to this document. I am also including a doctor's note from {Doctor} verifying that {Ill Person}, a resident of this house, is extremely ill and requires utilities for proper care.
Please consider our situation. I sincerely appreciate your understanding and assistance in this matter. Thank you.
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Index of Hardship Letter Examples