Date： _

　　To： _ [Supplier]

　　We received goods from you pursuant to our order or contract dated _， 19_.

　　We hereby reject said goods for the reason[s] checked below：

　　__ Goods were not delivered within required time.

　　__ Goods were defective as described on reverse side.

　　__ Goods were non-conforming to sample or specifications as stated on reverse side.

　　__ Notice of acceptance of our order， as required， has not been received， and we ordered the goods from other sources.

　　__ Prices for said goods do not conform to quote，catalogue or order.

　　__ Goods represent only a partial shipment.

　　__ Other [Describe] _

　　Please issue appropriate credits or refunds if prepaid，and provide instruction for return at your expense.  Rejection of said goods shall not be a waiver of any other claim we may have.

　　Very truly，

　　_______________________________