[Place and date]

Sender

[Full name]
[Correspondence address]
[Email address or telephone for the reply]

Recipient

[Full legal name of the recipient]
[Recipient address]

Complaint about an incorrectly recorded payment

I am submitting a complaint concerning a payment I made which has not been recorded or has been allocated incorrectly.

Agreement and payment details

[Agreement number; payment date and amount; recipient account; transfer description and reference]

Description of the error

[Explain the difference between the payment confirmation and the company statement. Specify dates and amounts requiring review.]

Requested outcome

Please locate the payment, explain its recording date and allocation, correct any inaccurate balance and charges resulting from the error, and provide an amended statement.

Additional request

[State any additional request and reasons, or enter none]

Reply

[Preferred reply method and correspondence or email address]

Attachments

[List copies of the documents attached or enter none]

[Legible signature for a paper letter]