HomeMy WebLinkAboutInv# PC - 4383 - SPOTIFY HQ - 05/19/2022June 2022
P-Card Statement Dispute Form
This form is provided to assist you should you believe a transaction on your statement is in error.
Regulations require that disputes be settled in 30 days, and thus should be addressed as soon as
possible.
Cardholder Name:
Vendor Name:
Transaction Date:
Transaction Amount:
Please check one of the following choices applicable to your dispute. Include all necessary
information / documentation, including a copy of the statement.
I do not recognize the above-mentioned charge.
I have been billed more than once by the same vendor. I authorized one charge with this vendor only.
Valid Charge $ ________ Reference # __________________ Transaction Date: ___________
Valid Charge $ ________ Reference # __________________ Transaction Date: ___________
I have not received the merchandise that was to be shipped to me on _____. I have requested credit.
Vendor was to issue credit for merchandise I returned to the store. I have enclosed a copy of my
credit receipt.
I have been billed for an incorrect amount. My receipt shows _______ however, I was billed _______.
I am providing a copy of my receipt showing the correct amount.
I did not authorize the above-mentioned charge. I have attempted to contact the vendor to resolve the
dispute but have been unsuccessful.
Work Phone E-mail:
Signature: Date:
1**CAUTION** This email originated from external sources. Do not open attachments OR click any links until you have verified the authenticity of the message and its contents. We have identified unusual activity on your credit card account ending in 2085. A transaction in the amount of $15.99 was attempted May 19, 2022 by Spotify USA. To prevent any disruptions in using your card, please call our Fraud Specialists toll-free at 1-866-500-8262 or the number on the back of your card.
2Thank You, Bank of America NOTE - This email message was sent from an automated system. Please do not reply to this email.