HomeMy WebLinkAboutInv# PC - 5938 - BANK OF AMERICA - 08/09/2022DANIA BEAC}..I
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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.
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Vendor Name: \-BOO- flOrrqrf S
rransaction Date: Z \q\ UJLL
Transaction Amount: .S laO, Zl
Please check one of the fo!lowing choices applicable to your dispute. lnclude ql! necessary
information / documentation, including a copy of the statement.
Transaction Date:
Transaction Date:
l_l , n"r" not received the merchandise that was to be shipped to me on I have requested credit.
n VenOor was to issue credit for merchandise I returned to the store. I have enclosed a copy of my
credit receipt.
l--l t n"r" 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.
X did not authorize the above-mentioned charge. I have attempted to contact the vendor to resolve theI dispute but have been unsuccessful.
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nt Oo not recognize the above-mentioned charge.
n, n"r" been billed more than once by the same vendor. I authorized one charge with this vendor only.
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Reference #
Reference #
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