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| 76. Assignment of Security Interest Form 77. Assignment of Trademark Form 78. Assignment of Trademark Form II 79. Assignment of a Claim for Damages Form 80. Assignment Form 81. Authorization to Direct Bill for Corporate Guest 82. Authorization to Participate in Medical Plan 84. Bid for the Purchase of Real Property [Probate] Form 85. Bill of Sale [with Warranty of Title] Form 87. Business Credit Application Form 88. Certificate of Abandonment of Fictious Business Name Form 89. Certificate of Satisfaction of Lien 90. Change of Address Awaiting Refund 91. Charge Account Credit Limit Raise Notification 92. Charge Account Terms and Conditions Form 93. Charge Back Application of Discount on Delayed Shipment 94. Collateral Decision, Request for Preparation of Loan Documents 95. Commendation and Refusal of Requests for Funds 96. Commendation on Good Suggestion 97. Commendation 98. Commitment Form [Advertising] 100. Company Credit Approval Letter
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Dear
The shipment of the above referenced merchandise was
delivered to my receiving department on ______________________________________ Our check for the full amount of the invoice, less our 2% discount, was mailed to you on _____________________________ I am enclosing a copy of the statement I received today, which includes a charge back for that discount, taken in compliance with your terms. I believe that the source of this error lies in the fact that the date on the invoice was not changed to reflect the delay in delivery. I would appreciate receiving a corrected statement of my account. Thank you for your cooperation in this matter.
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