WHEREAS, on ________________, _____________ received delivery of
the following described goods from _______________________: 

______________________________________

and, WHEREAS, the goods so described were non-conforming to the
contract because of: 

_________________________________

and, WHEREAS, on ________________, a demand for adequate assurance
was made to _______________________, 

Therefore, _____________ revokes its acceptance of the goods. 


Dated: _______________________________ 





________________________________________________ 
_____________ by an authorized officer