We acknowledge receipt of your bill dated ___________,
19__, indicating an account balance of $_______________. We
dispute said balance because
____ Goods have not been received.
____No credit for prior payment made in the amount of $_________.
____ Goods were not ordered.
____ Goods were defective as per prior notice.
____ Goods are available for return as per our rights of return and credit.
Please adjust our account.