________
________

________

________
________

RE: Account number ________, Cardholder ________

To Whom It May Concern:

In reviewing my statement from the following time period: ________, I feel that I have been charged an incorrect amount for the following transaction:

________ -- ________, in the amount of $________, transaction number ________. The amount of the charge should have been $________.

I have enclosed with this letter the following evidence of this situation:

________

Please send me a copy of the charge slip or other evidence of the above charge(s) for my review.

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

Please contact me at the above address if you have any questions or need additional information.

Thank you in advance for your prompt attention to this matter.

Sincerely,

___________________________________
________

Enclosure