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Fedkz. Invoice Number:
Invoice Date:
Account Number:
Sep 02.2005
Page: 1 of 3
FedEx Tax ID: 71-0427007
Billing Account Shipping Address: Invoice Questions?
Contact FedEx Revenue Services
INSMIluS Phone ti100[ 622.1147 ?.6F 7.6 (CST)
Fax: (800) 548.3020
Internet: vnwe.tedex.com
Invoice Summary Sep 02, 2005
FedEx Express Services FedEx News!
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Transportation Charges 14.51
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Special Handing Charges 1.82
Kinko s online al fedexknkos.com,fp4k-fs. While there.
you can learn about File. Print FedEx Kinko s . The FREE
Total Charges USD.S. 16.33 File. Print FedEx Knko s software allows you to select
printing and binding options, see a preview and even
TOTAL THIS INVOICE.- _._USD $ 16.33 arrange FedEx shipping for your completed document.
We re even giving away exciting monthly prizes to customers
just for using File. Print FedEx Kinko s. Leam mare and
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The FecEx Ground accounts referenced in this invoice have been **(erred and sinned lo. are owned by. and we payable to FedEx Express.
To ensure pricer crech.owace 'shin Um POiliTI Vigh yOLV owner,* Fete.
Plate do A0111400 a lob. PIPTILD rfAk0 your Nock payable to Ebb.
0 For Wing° or widow. Wick here rid co**, low on townies* Invoice Account Amount
Number Number Due
Remittance Advice
Your payment is due by Sep 17. 2005 USD $ 16.33
11,11 11..1.11
FedEx
P.O. Box 371461
Pittsburgh PA 15250-7461
EFTA00219089
Invoice Number:
Invoice Date: Sep 02.2005
Account Number:
Page: 2 of 3
Adjustment Request
FAX TO (800) 548-3020
Tracking No..Airbill No. Reason Code Explanation
{¢FORE YOU FAX
REASON CODE KEY
Reason
Please kiclude detailed explanation for each adjustment request. Code Description
DUP Duplicate Eking
Remember to include recipient's account number or third party's PND Shipment Never Sent
account number if applicable. RATE Incorrect Rates or Pieces
RRA Rebill Recipient - Include
Recipient's Account No.
From:
RSA Rebill Sender
RTA Rebill Thit Party - Include
Third Party's Account No.
Name Date
SUR Incorrect Surcharge -
Please Explain
OTHR Other - Please Explain
Business Phone Business Fax
This form cannot be used to request Invoice Adjustments due to Service Failures or lack of a POD.
To request adjustments for Service Failures or lack of a POD. please call 1-800-622-1147.
visit our internet site at www.ledex.com or register for FIO.
Fedtz
Federal Express
Please Indicate change In address for the account a listed below E Physical Address ❑ Billing Address ❑ Mailing Address
Account Number:
Name:
Address: Apt.: Suite:
City: Zp
Phone (
Autheriring Signature:
EFTA00219090
Invoice Number:
Invade Date: Sep 02.2005
Account Number:
Page: 3 of 3
FedEx Express Shipment Detail By Payor Type (Original)
Picked up: Aug 29, 2005 Payor: Shipper Reference: NO REFERENCE INFORMATION
Fuel Surcharge FedEx has applied a fuel surcharge ol 12.50% so INs sNpment
Distance Based Pncing. Zone 5
Tracking ID Sender Recipient
Service Type FedEx Pnonty Overright FREDERICK L WHITE
Package Type FedEx Envelope NVSG LLC DEERFIELD TRIARE CAPITAL CORP
Zone 5
Packages 1 US
Weight NIA
Delivered Aug 30. 20050900 Transportation Charge 743
Svc Area Al Fuel Sischarge 0.93
Signed by E.EISENBERG
FedEx Use 201105900e0000192/ Total Charge USD S 8.36
Picked up: Aug 29. 2005 Payor: Shipper Reference: NO REFERENCE INFORMATION
Fuel Surcharge FedEx has applied a lust surcharge ol 12.50% to this shipment.
Distance Based Pncing. Zone 0
Tracking ID Sender Recipient
Service Type FedEx Priority OverrigN PEG UGLAN0
Package Type FedEx Envelope NVSG LLC NA PROPERTY INC
Zone 4
Packages 1 US
Weight NIA
Delivered Aug 30.200609:l8 Transportation Cling! 7 08 =
Svc Area A2 Fuel St:charge 0.99
Signed by CLOAKLY
FedEx Use 201105900e0000192/ Total Charge USD S 7.97
Shipment Detail Subtotal USD 16.33
EFTA00219091
ℹ️ Document Details
SHA-256
ea7c642c71fea3f4bedd809f39b089d778b7a19f5fe769340ce103729878a103
Bates Number
EFTA00219089
Dataset
DataSet-9
Type
document
Pages
3
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