We are in receipt of your statement dated ___________, 20 _, indicating an account balance of $ _______.
We dispute said balance for the reason(s) ticked.
_____ 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 rights of return and credit.
_____ Other (Describe)
Please adjust our account.