ISSUING OFFICE ADDRESS LINE 1-----X ISSUING OFFICE ADDRESS LINE 2-----X ISSUING OFFICE ADDRESS LINE 3-----X ISSUING OFFICE ADDRESS LINE 4-----X ISSUING OFFICE ADDRESS LINE 5-----X ISSUING OFFICE ADDRESS LINE 6-----X POSTCODE X
REPRINT-REFERENCE--X  
999
Unique tax reference (UTR) 
99999 99999
RECIPIENT NAME LINE 1 ------------X 
RECIPIENT NAME LINE 2 ------------X ADDRESS LINE 1 -------------------X ADDRESS LINE 2 -------------------X ADDRESS LINE 3 -------------------X ADDRESS LINE 4 -------------------X ADDRESS LINE 5 -------------------X POSTCODE X
Accounts Office reference
999PA99999999
CIS Unit telephone
99999 999999
Date
99 XXXXXXXXX 9999

## Construction Industry Scheme Contractor'S Monthly Return

We have received a Contractor's monthly return that we cannot match to our Construction Industry Scheme records. We believe it may belong to you for the Accounts Office reference above. We have tried to phone you without success. Please call the above number so we can help to resolve the matter. Until we are certain that the Contractor's monthly return belongs to you, we will continue to charge penalties on the outstanding return.