Disputed Balance Notice

DISPUTED BALANCE NOTICE






Date: _






To: _






We are in receipt of your statement dated _, 20_,
indicating an account balance of $_.
We dispute said balance for the reason(s) checked.


____ Goods billed for have not been received.
____ Prices are in excess of agreed amount.
____ Prior payment made in the amount of $_ on _, 20_.
____ Goods were unordered.
____ Goods were defective as per prior notice.
____ Goods are available for return as per our right of
return and credit.
____ Other (Describe) _


Please adjust our account.




Very truly,








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