your street
your town, state
zipcode. USA

Qwest
1033 NE 6th Ave.
Portland, Oregon
97256-0001
1-888-221-7070
# 12345678

I am leaving town and not sure when I will return so enclosed is my check for
$ . for the remainder of my bill to be applied to my account
# 12345678. This should pay this off in full. Please close this account and turn off my service to the above address.

Sincerely,


name