Notice of Withheld Delivery



To:  (Customer)



We refer to your order for certain goods dated the_____ day of __________, 201(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,




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