DOJ-OGR-00015429.jpg
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Document Information
Type:
Adjustment request form
File Size:
490 KB
Summary
This is a blank FedEx Adjustment Request form related to invoice number 4-495-33932, dated December 16, 2002, for account number 1144-2081-6. The form provides instructions and reason codes for customers to dispute charges by faxing the completed form to a specified number. It also provides a separate phone number for issues related to service failures.
Organizations (2)
| Name | Type | Context |
|---|---|---|
| FedEx | company |
The document is a form provided by FedEx for 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 (1,313 characters)
FedEx.
Invoice Number: 4-495-33932
Invoice Date: Dec 16, 2002
Account Number: 1144-2081-6
Page: 2 of 15
Invoice Date: Dec 16, 2002
Account Number: 1144-2081-6
Page: 2 of 15
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_00340781 120
DOJ-OGR-00015429
DOJ-OGR-00015429
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