COMMERCIAL 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, and mail with required enclosures within 60 days from the
    billing close date to:
     
    Bank of America – Commercial Card Services Operations
    P. O. Box 53142
    Phoenix, AZ 85072-3142
     
    FAX (888) 678-6046
     
    Company Name:
    Account Number:
    Cardholder Name:
     
    This Charge appeared on my statement, billing close date:
    Transaction Date:
    Reference Number:
    Merchant Name/Location:
    Posted Amount: Disputed Amount:
     
     
     
    _______________________ _______________________ __________ __________
    (Cardholder Signature) (Authorized Participant Signature) (Date) (Phone Number)
     
    Please Check Only One
     
    1._____
    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._____
    Charge Amount Does Not Agree With Order Authorizing the Charge:
    The amount entered on the sales slip was increased
    from $__________ to $__________. I have enclosed a copy of the unaltered sales slip.
    3._____
    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 __________. (Please describe your efforts to resolve this matter
    with the merchant, the date(s) you contacted them and their response.)
     
    4._____
    Defective or Wrong Merchandise:
    I returned the merchandise on __________ because it was (check one):
    _____ defective; _____wrong size; _____wrong color; _____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._____
    Recurring Charges After Cancellation:
    On __________ (date), I notified the merchant to cancel the monthly/yearly
    agreement. Since then my Bank of America account has been charged _____ time(s). (Please enclose a copy of the
    merchant’s confirmation of your cancellation request.)
    6._____
    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._____
    Credit Appears as a Charge:
    The enclosed Credit Voucher appeared as a charge on my Bank of America Commercial Card
    account.
    8._____
    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._____
    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.____
    Double or Multiple Charges:
    My Bank of America Commercial Card A
    ccount has been double charged. The valid charge
    appeared on __________ (date). The duplicate charge(s) appeared on _______________.
    11.____
    Do Not Recall the Transaction:
    The statement has an inadequate description of the charge. Please supply supporting
    documentation.
    12. ___
    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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