Today’s Date

Economic Development Administration
U.S. Department of Commerce
1401 Constitution Avenue, NW
HCHB Room 7009
Washington, DC 20230

To Whom It May Concern:

Our company respectfully requests the Secretary of Commerce to certify our firm eligible to receive adjustment assistance under the provisions of section 251 of the Trade Act of 1974, Public Law 93-613.

We are confident that your review of the accompanying data will confirm our contention that company sales and production have decreased appreciably; that numerous workers had to be separated; and that imports directly competitive with those produced by our firm have contributed to this decline.

Two sets of supporting documents and pertinent data are attached for your perusal.

Very truly yours,




Company Representative’s Name
Company Representative’s Title



Enclosures