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4/09/2011

Notice of Withheld Delivery

Date: _




To: _ (Customer)




Reference is made to your order for certain goods under

date of _, 20_.

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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