[Date]
[Name of Creditor]
[Address]
Dear Sir or Madam:
I am writing to dispute a billing error in the amount of [______] on my account. The amount is inaccurate because [describe the problem]. I am requesting that the error be corrected, that any finance and other charges related to the disputed amount be credited as well, and that I receive an accurate statement.
Enclosed are copies of [use this sentence to describe any information you are enclosing, like sales slips or payment records] supporting my position. Please investigate this matter and correct the billing error as soon as possible.
Sincerely,
[Your name]
Source: consumer.ftc.gov