Copyright Envision Corporation. 2002. All rights reserved.

Protected by the copyright laws of the United States & Canada and by International treaties. IT IS ILLEGAL AND STRICTLY PROHIBITED TO DISTRIBUTE, PUBLISH, OFFER FOR SALE, LICENSE OR SUBLICENSE, GIVE OR DISCLOSE TO ANY OTHER PARTY, THIS PRODUCT IN HARD COPY OR DIGITAL FORM. ALL OFFENDERS WILL BE SUED IN A COURT OF LAW.

December 9, 2011 Contact Name Address Address2 City, State/Province Zip/Postal Code

OBJECT: DISPUTED BALANCE NOTICE Dear [CONTACT NAME], We do hereby confirm that we are in receipt of a statement dated [DATE], indicating a balance of [AMOUNT] for our account [NUMBER]. After examination of our records, we dispute said balance for the following reason(s): ___ Goods billed for have not been received. ___ Prices are in excess of agreed amount. ___ Prior payment made in the amount of [AMOUNT] on [DATE]. ___ 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 accordingly. Do not hesitate to contact me so that we find a mutually acceptable compromise on this matter. Sincerely,

Your name Your title (800) 123-4567 youremail@yourcompany.com

Company Name Street, City, State/Province, Zip/Postal code Tel: (000) 000-0000 / Fax: (000) 000-0000 www.yourwebsite.com