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.