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                                             NOTICE-DISPUTED BALANCE

 
 

        Date:

  

        To:


 

               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.

 

               ____ Other

 

               Please adjust our account.

 

 

                                          Very truly,

 

 

                                         ____________________________