DOJ-OGR-00015409.jpg
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Extraction Summary
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Document Information
Type:
Financial record
File Size:
490 KB
Summary
This document is a blank FedEx Adjustment Request form dated December 9, 2002, associated with invoice number 4-495-05371 and account number 1144-2081-6. The form provides instructions and reason codes for submitting billing adjustment requests via fax and includes a section for updating the address on file. The form is not filled out.
Organizations (2)
| Name | Type | Context |
|---|---|---|
| FedEx | Company |
The document is a form from FedEx for requesting a billing adjustment.
|
| Federal Express | Company |
Mentioned under the FedEx logo in the address change section.
|
Full Extracted Text
Complete text extracted from the document (1,303 characters)
FedEx.
Invoice Number: 4-495-05371
Invoice Date: Dec 09, 2002
Account Number: 1144-2081-6
Page: 2 of 6
Invoice Date: Dec 09, 2002
Account Number: 1144-2081-6
Page: 2 of 6
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
[ ] Physical Address [ ] Billing Address [ ] Mailing Address
Account Number 1144-2081-6
Name:
Address:
Apt. / Suite:
City:
State:
Zip:
Phone: ( )
Fax: ( )
Authorizing Signature:
Federal Express
Please indicate change in address for the account # listed below
[ ] Physical Address [ ] Billing Address [ ] Mailing Address
Account Number 1144-2081-6
Name:
Address:
Apt. / Suite:
City:
State:
Zip:
Phone: ( )
Fax: ( )
Authorizing Signature:
CONFIDENTIAL
SDNY_GM_00340775 100
DOJ-OGR-00015409
SDNY_GM_00340775 100
DOJ-OGR-00015409
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