CARDHOLDER'S INQUIRY CONCERNING BILLING ERROR

TO:  ________________________

     ________________________ 

Name of cardholder:  _______________________________

Cardholder's address:  _____________________________

Credit Card account Number:  _______________________

On the periodic billing statement dated ____________, 20___, for the above-numbered credit card account, I determined there was 
a billing error; specifically:


It is my belief that the posting of such debit is incorrect because:


Please be advised that the billing error described above does not concern any dispute with respect to value, quality, or quantity of the goods obtained through use of my 
credit card.

I would appreciate that the billing error be corrected, or that you otherwise respond to this inquiry, at your earliest convenience.

Dated ______________________, 20___.

__________________________