DOJ-OGR-00015311.jpg
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Document Information
Type:
Form
File Size:
488 KB
Summary
This document is a blank FedEx "Adjustment Request" form associated with an invoice dated November 4, 2002, for account number 1144-2081-6. The form is intended to be faxed to FedEx to dispute charges for reasons such as duplicate billing, incorrect rates, or shipments never sent. It also provides a separate phone number for handling adjustments related to service failures.
Organizations (2)
| Name | Type | Context |
|---|---|---|
| FedEx | Company |
The company providing the form and shipping services, to whom the adjustment request is sent.
|
| Federal Express | Company |
Mentioned below the FedEx logo in the address change section.
|
Full Extracted Text
Complete text extracted from the document (1,291 characters)
FedEx.
Invoice Number: 4-447-12299
Invoice Date: Nov 04, 2002
Account Number: 1144-2081-6
Page: 2 of 8
Invoice Date: Nov 04, 2002
Account Number: 1144-2081-6
Page: 2 of 8
Adjustment Request
FAX TO (800) 548-3020
FAX TO (800) 548-3020
Tracking No./Airbill No.
Reason Code
Explanation
Reason Code
Explanation
BEFORE YOU FAX
Please include detailed explanation for each adjustment request.
Remember to include recipient's account number or third party's account number if applicable.
Please include detailed explanation for each adjustment request.
Remember to include recipient's account number or third party's account number if applicable.
From:
Name
Date
Business Phone
Business Fax
Name
Date
Business Phone
Business Fax
REASON CODE KEY
Reason Code Description
DUP Duplicate Billing
PND Shipment Never Sent
RATE Incorrect Rates or Pieces
RRA Rebill Recipient - Include Recipient's Account No.
RSA Rebill Sender
RTA Rebill Third Party - Include Third Party's Account No.
SUR Incorrect Surcharge - Please Explain
OTHR Other - Please Explain
Reason Code Description
DUP Duplicate Billing
PND Shipment Never Sent
RATE Incorrect Rates or Pieces
RRA Rebill Recipient - Include Recipient's Account No.
RSA Rebill Sender
RTA Rebill Third Party - Include Third Party's Account No.
SUR Incorrect Surcharge - Please Explain
OTHR Other - Please Explain
This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD.
To request adjustments for Service Failures or lack of a POD, please call 1-800-622-1147,
visit our internet site at www.fedex.com or register for FIO.
To request adjustments for Service Failures or lack of a POD, please call 1-800-622-1147,
visit our internet site at www.fedex.com or register for FIO.
FedEx
Federal Express
Please indicate change in address for the account # listed below
Account Number 1144-2081-6
Physical Address
Billing Address
Mailing Address
Federal Express
Please indicate change in address for the account # listed below
Account Number 1144-2081-6
Physical Address
Billing Address
Mailing Address
Name:
Address:
Apt. / Suite:
City:
State:
Zip:
Phone: ( )
Fax: ( )
Authorizing Signature:
Address:
Apt. / Suite:
City:
State:
Zip:
Phone: ( )
Fax: ( )
Authorizing Signature:
CONFIDENTIAL
SDNY_GM_00340672
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DOJ-OGR-00015311
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DOJ-OGR-00015311
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