DOJ-OGR-00015365.jpg
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Extraction Summary
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Document Information
Type:
Business form
File Size:
489 KB
Summary
This is a blank FedEx Adjustment Request form related to invoice number 4-474-29369, dated November 18, 2002, for account number 1814-9779-3. The form is designed to be faxed to FedEx to dispute billing issues such as duplicate charges or incorrect rates. It explicitly states that it cannot be used for service failures, for which customers are directed to call a separate phone number.
Organizations (2)
| Name | Type | Context |
|---|---|---|
| FedEx | Company |
The company that issued the invoice and provided the adjustment request form.
|
| Federal Express | Company |
Listed as the full name for FedEx on the lower portion of the form.
|
Full Extracted Text
Complete text extracted from the document (1,310 characters)
FedEx.
Invoice Number: 4-474-29369
Invoice Date: Nov 18, 2002
Account Number: 1814-9779-3
Page: 2 of 4
Invoice Date: Nov 18, 2002
Account Number: 1814-9779-3
Page: 2 of 4
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 1814-9779-3
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 1814-9779-3
Name:
Address: Apt. / Suite:
City: State: Zip:
Phone: ( ) Fax: ( )
Authorizing Signature:
CONFIDENTIAL
SDNY_GM_00340718 56
DOJ-OGR-00015365
SDNY_GM_00340718 56
DOJ-OGR-00015365
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