ࡱ> _ Ubjbjzz 8dB\B\  rrrrr8l*l1`PD$h8_:_:_:_:_:_:_$bd^_rQ#PPQ#Q#^_rr4_C&C&C&Q#jrr8_C&Q#8_C&C&W@[0##(X,$_`01`XWe#WeX@[Wer@[ hC& TJ!^_^_%X1`Q#Q#Q#Q#We > 8: PURCHASING CARD CLAIMS STATEMENT OF DISPUTED ITEM Instructions:Your company should first make good-faith efforts to settle a claim for purchases directly with the merchant. If assistance from Bank of America is required, please complete this form. E-Mail or FAX completed form with required enclosures within 60 days from the billing close date to: Bank of America  Business Card Services Operations P. O. Box 53101 Phoenix, AZ 85072-3101 FAX (888) 678-6046 Company Name: FORMTEXT      Account Number: FORMTEXT      Cardholder Name: FORMTEXT       This Charge appeared on my statement, billing close date: FORMTEXT      Transaction Date: FORMTEXT      Reference Number: FORMTEXT      Merchant Name/Location: FORMTEXT      Posted Amount: FORMTEXT     Disputed Amount: FORMTEXT      Original Sales Slip Requested:  FORMDROPDOWN  _______________________ _______________________  FORMTEXT        FORMTEXT       (Cardholder Signature) (Authorized Participant Signature) (Date) (Phone Number) Please Check Only One (After choosing one of the following options, feel free to provide additional details regarding the transaction on a separate piece of paper) 1. FORMTEXT       Unauthorized Transaction: I did not authorize, nor did I authorize anyone else to engage in this transaction. No goods or services represented by the above charge were received by me or anyone I authorized. My Bank of America card was in my possession at the time of the transaction.2. FORMTEXT      Charge Amount Does Not Agree With Order Authorizing the Charge: The amount entered on the sales slip was increased from $ FORMTEXT       to $ FORMTEXT      . I have enclosed a copy of the unaltered sales slip.3. FORMTEXT      Merchandise or Services Not Received: I have not received the merchandise or services represented by the above transaction. The expected date of delivery of services was  FORMTEXT      . (Please describe your efforts to resolve this matter with the merchant, the date(s) you contacted them and their response.)4. FORMTEXT      Defective or Wrong Merchandise: I returned the merchandise on  FORMTEXT      because it was (check one):  FORMTEXT      defective;  FORMTEXT      wrong size;  FORMTEXT      wrong color;  FORMTEXT      wrong quantity. (Please describe your efforts to resolve this matter with the merchant, the date(s) you contacted them, their response and proof of the return of merchandise. Please provide a detailed description of the wrong or defective nature of the merchandise.)5. FORMTEXT      Recurring Charges After Cancellation: On  FORMTEXT      (date), I notified the merchant to cancel the monthly/yearly agreement. Since then my Bank of America account has been charged  FORMTEXT      time(s). (Please enclose a copy of the merchant s confirmation o23` b 0 2 F H J T V Ĺ|fP|:P+jh\hzCJOJQJUaJ*jh\CJOJQJUaJmHnHu+jTh\hzCJOJQJUaJh\CJOJQJaJjh\CJOJQJUaJh"heUCJ OJQJaJ #h"heU5CJOJQJ^JaJh"heUCJaJh"heU5CJOJQJaJ"h"heU5CJOJQJ\aJh"heUCJOJQJaJh"heUCJaJ23A` a b vnningdeU$a$gdeUEkd$$Ifl0L+'4 la $ & F VVL<<$If^V`La$gdL$<<$If]^a$gdE`gdeUgdeU   0 X Z | WEkd$$Ifl0*f$4 laEkd$$Ifl0*f$4 la$$If]^a$gdE`$a$gdeU V | ~   2 4 6 @ B j l տwgQg+jhOBhzCJOJQJUaJjh9OnCJOJQJUaJ+jhOBhzCJOJQJUaJhOBCJOJQJaJjhOBCJOJQJUaJ*jh\CJOJQJUaJmHnHu+jh\hzCJOJQJUaJh\CJOJQJaJjh\CJOJQJUaJh"heUCJOJQJaJ  D F j OEkd=$$Ifl0*4 la$$If]^a$gdE`$]^a$gdeUEkd\$$Ifl0T*H$4 la  : _Ekd$$Ifl0*#4 la$$If]^a$gdE`Ekd$$Ifl0*f$4 la   ( * , 6 8 Z \ p r ~ ٴ٨ٴv`vJ+jh9OnhzCJOJQJUaJ+jh9OnhzCJOJQJUaJh9OnCJOJQJaJjh9OnCJOJQJUaJ+jNhOBhzCJOJQJUaJhOBCJOJQJaJh"heUCJOJQJaJ*jhOBCJOJQJUaJmHnHujhOBCJOJQJUaJ+j{hOBhzCJOJQJUaJ: < Z 9kkd]$$Ifl\TV* 4 la$$If]^a$gdE`Ekd$$Ifl0*6 !4 la ( * , 6 8 246@BDhᄇjTjIh"heUCJaJ+ji hOBhzCJOJQJUaJ*jhOBCJOJQJUaJmHnHu+jhOBhzCJOJQJUaJjhOBCJOJQJUaJhOBCJOJQJaJhL CJOJQJaJh"heUCJOJQJaJ+jh\hzCJOJQJUaJh\CJOJQJaJjh\CJOJQJUaJ . 0 2 4 6 8 FfhupgdeU &dPgdeUgdeU$a$gdeU[kd$$Ifl4FV*    4 laf4$$If]^a$gdE` $&(<>@JLNDʻscMsc+j hOBhzCJOJQJUaJhe8heU5CJOJQJaJ*jhOBCJOJQJUaJmHnHu+j hOBhzCJOJQJUaJhOBCJOJQJaJjhOBCJOJQJUaJhe8heUCJOJQJaJh"heUCJOJQJaJh"heUCJaJh"heU5CJ\aJh"heU5CJ\aJ "N4PJkd $$Ifl0L*8`'+4 laJkdU $$Ifl0L*8`'+4 la$$If^a$gdE` $IfgdE`DFZ\^hjtv "$&024拓v`JAhe8heUaJ*jhOBCJOJQJUaJmHnHu+jo hOBhzCJOJQJUaJhOBCJOJQJaJjhOBCJOJQJUaJ+j h9OnhzCJOJQJUaJhe8heUCJOJQJaJ*jh9OnCJOJQJUaJmHnHu+j h9OnhzCJOJQJUaJh9OnCJOJQJaJjh9OnCJOJQJUaJ\^u_O?jhrCJOJQJUaJhe8heU5CJOJQJaJ*jhOBCJOJQJUaJmHnHu+j hOBhzCJOJQJUaJhOBCJOJQJaJjhOBCJOJQJUaJhe8heUCJOJQJaJhe8heUaJ!jhr5UaJmHnHu"j hrhz5UaJ hr5aJjhr5UaJhe8heU5aJ4>Jkd$$Ifl0L*8`'+4 la$$If^a$gdE` $IfgdE`Lkdk $$Ifl0L*8`'+4 la$$If^a$gdE`^rtv68LNPZ\vxθΩθΩ}θΩgθΩQ+j!hrhzCJOJQJUaJ+jhrhzCJOJQJUaJ+j5hrhzCJOJQJUaJ+jhrhzCJOJQJUaJhe8heUCJOJQJaJ*jhrCJOJQJUaJmHnHujhrCJOJQJUaJ+j9hrhzCJOJQJUaJhrCJOJQJaJ*68LNPZ\Z\pr˻sgQg;+jhrhzCJOJQJUaJ+jahrhzCJOJQJUaJhrCJOJQJaJhe8heU5CJOJQJaJ*jhOBCJOJQJUaJmHnHu+jhOBhzCJOJQJUaJhOBCJOJQJaJjhOBCJOJQJUaJhe8heUCJOJQJaJjhrCJOJQJUaJ*jhrCJOJQJUaJmHnHuDjD*H,HXHTIPJkd)$$Ifl0L*8`'+4 laJkd_$$Ifl0L*8`'+4 la$$If^a$gdE` $IfgdE`rt~DBDDDXDZD\DfDhDjDD0H2HFHHHJHTHVHXHHZI\IpIʸpʸZpʸ+j}hOBhzCJOJQJUaJhe8heU5CJOJQJaJ*jhOBCJOJQJUaJmHnHu+jhOBhzCJOJQJUaJhOBCJOJQJaJjhOBCJOJQJUaJUhe8heUCJOJQJaJ*jhrCJOJQJUaJmHnHujhrCJOJQJUaJf your cancellation request.)6. FORMTEXT      Recurring Charges Already Paid by Other Means: I already paid for the goods and/or services represented by the above charge by means other than my Bank of America Commercial Card. (Please provide a copy of the front and back on the cancelled check, money order, cash receipt, credit card statement, or other documentation as proof of purchase/payment. Describe your efforts to resolve this matter directly with the merchant, the date(s) you contacted them, and their response.)7. FORMTEXT      Credit Appears as a Charge: The enclosed Credit Voucher appeared as a charge on my Bank of America Commercial Card account.8. FORMTEXT      Credit From Merchant Not Received: I did not receive credit for the enclosed Credit Voucher within 30 calendar days from the date it was issued to me by the merchant shown above. (Please describe your efforts to resolve this matter with the merchant, the date(s) you contacted them and their response. Provide a detailed statement explaining your reason(s) for disputing this charge.)9. FORMTEXT      Hotel Reservation Cancelled: I made a reservation with the above hotel which I later cancelled on __________ (date) at __________ (time). I received a cancellation number which is _______________. (Please describe how the reservation was cancelled, proof of cancellation and attempts to resolve this issue with the merchant. _____ I was not given a cancellation number. _____ I was not told at the time that I made the reservation that my account would be charged for a  No Show . _____ I was not informed of the cancellation policy.10. FORMTEXT       Double or Multiple Charges: My Bank of America Commercial Card Account has been double charged. The valid charge appeared on  FORMTEXT      (date). The duplicate charge(s) appeared on  FORMTEXT      11. FORMTEXT      Do Not Recall the Transaction: The statement has an inadequate description of the charge. Please supply supporting documentation.12.  FORMTEXT      Other; Above Descriptions Do Not Apply: Please attach a detailed letter explaining the reason for your dispute and your attempts to resolve this issue with the merchant.     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[ @Verdana;Wingdings?= *Cx Courier NewA$BCambria Math"1hH'H'Rf % %4 3QHP ?E2!xx Bank of America Dispute FormDOASBeverly Kent AmiotX              Oh+'0   @ L X dpx Bank of America Dispute FormDOASNormalBeverly Kent Amiot2Microsoft Office Word@@أ7 @V@V՜.+,D՜.+,L hp  DOAS%  Bank of America Dispute Form TitleL# C O c w '3?_AdHocReviewCycleID_NewReviewCycle_EmailSubject _AuthorEmail_AuthorEmailDisplayName_ReviewingToolsShownOnce Publish_Date Community ContentType DOAS_Application Doc_Number SPD_Card_CategoryDOAS_Division Doc_CategoryDoc_Description Doc_OwnerRevision_ReasonOrder7display_urn:schemas-microsoft-com:office:office#EditorRevision_Date xd_Signature TemplateUrl xd_ProgID7display_urn:schemas-microsoft-com:office:office#AuthorExpiration_Date _SourceUrl_SharedFileIndex;e}Missing P-card FormMaggie.Clarke@doas.ga.govClarke, Maggie2009-02-16T11:58:00Z Document ;#-n/a-;#;#Purchasing Card;#SPD-none-Bank of America official form required when a cardholder disputes a transaction on the monthly billing statement (does not have an official SPD form number because it is the Banks form) SPD Card Program100.000000000000System AccountSystem Account  !"#$%&'()*+,-./012456789:;<=>?ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrtuvwxyz|}~Root Entry F m@ Data 3E1Table@eWordDocument8dSummaryInformation(sDocumentSummaryInformation8{MsoDataStore pU0#D02C2T0YHQ==2pU0AItem  PropertiesIZ13EHZEK2KAPGQ==2 pU0Item  PropertiesSXECAGMX0M==2pU0#Item PropertiesO This value indicates the number of saves or revisions. The application is responsible for updating this value after each revision.   !"$ DocumentLibraryFormDocumentLibraryFormDocumentLibraryForm   F Microsoft Word 97-2003 Document MSWordDocWord.Document.89qCompObj#rRoot Entry F*4Data 3E1Table@eWordDocument8d  !"$&'()*+,-./0123456789:;<=>?@A%  Bank of America Dispute Form Title|      ( 4LXdp|_AdHocReviewCycleID_NewReviewCycle_EmailSubject _AuthorEmail_AuthorEmailDisplayName_ReviewingToolsShownOnce Publish_Date Community ContentType DOAS_Application Doc_Number SPD_Card_CategoryDOAS_Division Doc_CategoryDoc_Description Doc_OwnerRevision_ReasonOrder7display_urn:schemas-microsoft-com:office:office#EditorRevision_Date xd_Signature TemplateUrl xd_ProgID7display_urn:schemas-microsoft-com:office:office#AuthorExpiration_Date _SourceUrl_SharedFileIndex2009-02-16T11:58:00Z Document ;#-n/a-;#;#Purchasing Card;#SPD-none-Bank of America official form required when a cardholder disputes a transaction on the monthly billing statement (does not have an official SPD form number because it is the Banks form) SPD Card Program100.000000000000System AccountSystem AccountSummaryInformation(sDocumentSummaryInformation8%MsoDataStore pU0#D02C2T0YHQ==2pU0AtomXml">  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q՜.+,D՜.+,L hp  DOAS  !"#$%&'()*+,-./012456789:;<=>?ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrtuvwxyz