Notice of Withheld Delivery

Date: _

To: _ (Customer)

Reference is made to your order for certain goods under
date of _, 19_.
We are withholding delivery for the reason(s) checked:
__ Required payment has not been made.
__ You repudiated or withdrew your contract to buy.
__ You failed to furnish requested shipping instructions.
__ Certain goods are back ordered and shipment will be
made in single lot.
__ Other (Describe)

Very truly,


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