Request for Verification of Receivable During Audit

Dear
In connection with an examination of our financial

statements by (name of accounting firm), Certified

Public Accountants, (address)(city)(state)(zip)

we will appreciate it if you will indicate the

correctness of the following information.
Our records indicate that, at the close of business on

(date) , the amount payable on your account was $ .
Please sign the confirmation form in the space provided

below if this amount agrees with your records. If it

does not agree, do not sign below but explain and sign

on the reverse side. Please return this form directly

to our accountants in the enclosed envelope.