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Credit Card Statement Inquiry Letter - Template Form Pro · US-law

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Credit Card Statement Inquiry Letter - Template Form
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BILLING ERROR DISPUTE NOTICE
Submitted Pursuant to the Fair Credit Billing Act, 15 U.S.C. § 1666, and Regulation Z, 12 C.F.R. § 1026.13

________
________
Telephone: ________
Email: ________

________

Sent via: ________
Tracking/Certified Mail No.: ________

________
Attn: Billing Inquiries / Billing Error Department
________

RE: Notice of Billing Error — Account Number ________; Cardholder ________

To Whom It May Concern:

This letter constitutes my written notice of a billing error under the Fair Credit Billing Act, 15 U.S.C. § 1666, and its implementing regulation, 12 C.F.R. § 1026.13 (Regulation Z). This notice is being delivered to the address you have designated for billing inquiries and is being sent so as to be received by you within sixty (60) days after the first periodic statement reflecting the alleged error was sent to me, as required by 15 U.S.C. § 1666(a).

The following information identifies me and the disputed item, as required by 12 C.F.R. § 1026.13(b):

(a) Cardholder Name: ________
(b) Account Number: ________
(c) Statement Period in Question: ________

Upon reviewing the periodic statement covering the above period, I have identified the following transaction that reflects an incorrect amount (a billing error within the meaning of 15 U.S.C. § 1666(b)):

Transaction Date: ________
Merchant/Business: ________
Amount Charged: $________
Transaction/Reference Number: ________
Amount That Should Have Been Charged: $________
Amount in Dispute: $________

The nature of the error and the reasons I believe it to be incorrect are as follows: ________

In support of this dispute, I have enclosed the following documentation:

________

I have also enclosed a copy of my periodic statement with the transaction(s) in question highlighted for your convenience.

Pursuant to 12 C.F.R. § 1026.13(c), I request that you:

Please direct all correspondence regarding this matter to me at the address set forth above. You may contact me at the telephone number or email address listed if you have any questions or require additional information.

Thank you for your prompt attention to this matter. I look forward to your written acknowledgment and a timely resolution of this dispute in accordance with applicable federal law.

Sincerely,


___________________________________
________
Date: ________

Enclosures: ________

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