YourCompanyName□Address:□TEL:+ToCompanyName25th.Oct.2010AddrressTelAttn:DearSirs/MadamsYouraboveaccountwithushasbeenDebitedasperdetailsgivenbelowPleasearrangeyourpaymentasperourmutualagreementReason:Currency:TotalAmount:BankInformation:Bankname&Address:SIGNEDBYName/TitleDEBITNOTEDATE: