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Here's the info you'll need to have handy to complete your doc:
Who it's going to
Make sure to have the full legal name of the infringing company, as well as the full name and title of the person at that company who will be signing the certification.
Have a list of all the ways the company was infringing your trademark. Be sure to have a description on how the company was using your mark. For example, was your mark being used to sell clothing? Or was it being used to advertise the company?
What's a Certification of Cease and Desist?
You've created a brand name and built a reputation for quality and service. Unfortunately, business rivals may want to cash in on your hard work by using a brand name or symbol that looks like yours. This can cause confusion among your customers. Keep your trademark by defending it. After sending a cease and desist letter, use this certification to acquire a formal and written promise from a competitor that they will stop using your mark for their gain.