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A short, simple, request letter is all you need. Using a standard business letter format (traditional, semi-block, full-block):

Dear....,

I am writing to request a letter outlining my employment with XXX Company.

I worked for XXX from June 2000 to January 2003 in the position of xx xx. The letter should include the duties and responsibilities of my position and (whatever else that the letter should include). The letter should be addressed 'To Whom It May Concern'.

Your time and effort is appreciated. If you have any questions, you may contact me at (phone number and/or email address). You may send the letter to my attention at my address above. Thank you.

Sincerely,

Name

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