DISPUTED BALANCE NOTICE
　　Date： _
　　To： _
　　We are in receipt of your statement dated _， 19_，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 _， 19_.
　　____ 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。