Date:
To: (Customer)
We refer to your order for certain goods dated
the_____ day of
__________, 200(x).
We are withholding delivery for the reason (s) checked below:
_____ Required payment has not been made.
_____ You repudiated or withdrew your contract to buy.
_____ You failed to furnish required shipping instructions.
_____ Certain goods are back ordered and shipment will be made in single lot.
_____ Other: ________________________________________________
Yours very truly,
_________________
Macrotwin Company / www.FreeBusinessForms.com