DOJ-OGR-00015400.jpg

489 KB

Extraction Summary

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Document Information

Type: Business form
File Size: 489 KB
Summary

This document is a blank FedEx Adjustment Request form associated with invoice number 4-494-69923, dated December 2, 2002. The form provides instructions and reason codes for a customer to dispute charges via fax and includes a section for updating account address information. It specifies that adjustments for service failures must be handled by calling a separate phone number.

Organizations (2)

Name Type Context
FedEx Company
The document is a form from FedEx for requesting invoice adjustments.
Federal Express Company
Mentioned under the FedEx logo in the address change section.

Full Extracted Text

Complete text extracted from the document (1,297 characters)

FedEx.
Invoice Number: 4-494-69923
Invoice Date: Dec 02, 2002
Account Number: 1144-2081-6
Page: 2 of 5
Adjustment Request
FAX TO (800) 548-3020
Tracking No./Airbill No.
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.
From:
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
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.
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:
Apt. / Suite:
Address:
City:
State:
Zip:
Phone: ( )
Fax: ( )
Authorizing Signature:
CONFIDENTIAL
SDNY_GM_00340756
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DOJ-OGR-00015400

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