Request For The Following Account Details

Date:_

To:_

Dear ______:

In connection with an examination of our financial statements by _______________, Certified Public Accountants, of

(address),

(city)

(state)

(zipcode)

we will appreciate it if you will indicate the correctness of the following information.

Our records indicate that, at the close of business on (date), the amount payable on your account was $ _______.

Please sign the confirmation form in the space provided below if this amount agrees with your records. If it does not agree, do not sign below but explain and sign on the reverse side.

Please return this form directly to our accountants in the enclosed envelope.

Yours truly,

___________________________

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