Attorneys

Quality Legal Resources You Can Count On

Bill Adjustment Request

Complete all the form fields and click the "Make My Letter" button to generate a letter you can print and use to notify a company to adjust the bill they sent you because you felt it was in excess of what you should have been charged for the services rendered. Excess and adjusted amounts will be automatically calculated when you enter the quote and invoice amounts.

Click here for a sample. All information appearing in bold type are the form fields that the program completes either automatically or with the information you supplied on this form.

Your Name:
Your Address:
City:
State or Province:
(Select a state or Canadian province)
Zip/Postal Code:
Country:
Your Phone Number:
(Please include area code)
Company:
Street Address:
City:
*State or Province:
(Select a state for U.S. clients or a Canadian province)
*Zip/Postal Code:
*Country:
Date of Invoice://
(Select the month, day and year services were rendered)
Services Rendered:
(Describe the services rendered for you by the vendor company. Press the <ENTER> key twice to start a new paragraph.)
Quoted Amount:
(For what amount did the company quote you on the services rendered?)
Invoiced Amount:
(How much was the actual invoice for?)

This form is not a substitute for legal advice, and it is suggested that an attorney be consulted.