NOTICE-DISPUTED BALANCE



                                       Date:



        To:  




               We acknowledge receipt of your bill dated ___________,  
        
        20__, indicating an account balance of $_______________.  We 
        
        dispute said balance because


               ____ Goods have not been received.

               ____No credit for prior payment made in the amount of
               $_________.

               ____ Goods were not ordered.

               ____ Goods were defective as per prior notice.

               ____ Goods are available for return as per our rights of 
               return and credit.

               ____ Other 

               Please adjust our account.



                                          Very truly,



                                         ____________________________


                                                      Form 321