12/22/2024 12:09:46 AM
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Corporate Account Dispute - Billing
Corporate Account Customer Service Request - Billing
The completed form must be submitted within 90 days from the date of the invoice. A separate form must be submitted for each disputed rental. 
Please include Rental Agreement Number or Invoice Number to expedite our research.
Corporate Account Dispute - Billing
*
Required field
Date of Invoice
Invoice Number
Please enter Corporate Account Name
(Comments Validation1271)
*
Corporate Account Name
Disputed Amount
Please enter a Rental Location
(Comments Validation1272)
Please enter a Corporate CD number.
(Comments Validation1274)
*
Rental Location
*
CDP #
Please enter your first name.
(Comments Validation1100)
Please enter your last name.
(Comments Validation1102)
*
Renter's First Name
*
Renter's Last Name
Rental Agreement #
Please enter a pick-up date.
(Comments Validation1193)
Please enter a return date.
(Comments Validation1273)
*
Pick-up date
*
Return Date
Person to Contact:
Please enter your first name.
(Comments Validation1100)
Please enter your last name.
(Comments Validation1102)
*
Contact First Name
*
Contact Last Name
Title
Address
Phone Number
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City
Fax Number
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State/Province
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(Comments Validation1125)
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(Comments Validation1281)
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