DOJ-OGR-00015374.jpg
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Extraction Summary
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Document Information
Type:
Adjustment request form
File Size:
489 KB
Summary
This is a blank FedEx Adjustment Request form dated November 25, 2002, associated with invoice number 4-494-19676 and account number 1144-2081-6. The form allows a customer to dispute charges by providing a tracking number, reason code, and explanation, and then faxing the request to (800) 548-3020. It explicitly states it cannot be used for service failures, for which a different phone number is provided.
Organizations (2)
| Name | Type | Context |
|---|---|---|
| FedEx | company |
The document is an official form from FedEx for requesting invoice adjustments.
|
| Federal Express | company |
Mentioned under the FedEx logo in the lower section of the form.
|
Full Extracted Text
Complete text extracted from the document (1,304 characters)
FedEx.
Invoice Number: 4-494-19676
Invoice Date: Nov 25, 2002
Account Number: 1144-2081-6
Page: 2 of 10
Invoice Date: Nov 25, 2002
Account Number: 1144-2081-6
Page: 2 of 10
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_00340734
65
DOJ-OGR-00015374
65
DOJ-OGR-00015374
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