Date: ________

To: _____________

We have purchased a product sold or manufactured by you described as:

__________________________________________________________________

________________________________________________________________________

One of our customers has advised us of a product defect in the following particulars:

Name of customer: ______________________

Approximate date of purchase: _____________

Nature of defect: ________________________________________

Injuries claimed: ______________________________

In the event suit is brought against us arising from Breach of Warranty of Merchantability, we shall in a like manner look to you for full reimbursement.

This letter is provided to give you earliest possible notice of a potential claim.

Very truly,

______________________________

After recording, mail to:

______________________________

______________________________ (Name and address)