![](_page_0_Picture_0.jpeg) NYSG LLC 457 MADISON AVE NEW YORK NY 10022-6843 ### Invoke Number: Invoice Date: Aug 26.2005 Account Number: Page: 1 of 3 FedEx Tax 71-0427007 # Invoice Questions? Contact FedEx Revenue Services Phone 622.1147 /.1.F 7.6 (CST1 Fax: (800) 548.3020 Internet: vnnv.fedex.com ### Invoice Summary Aug 26, 2005 | FedEx Express Services | | FedEx News! | | --------------------------------- | ------ | --------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | Transportation Charges | 63.00 | Win a 50 Plasma TV from FedEx 1Gnko s! Now through | | Base Discount | -23.50 | Sept. 30. 2005. enter to win a 50 Plasma TV from FedEx | | Special Handing Charges | 4.94 | Kinko s online al fedexknkos.com,fp4k-fs. While there.
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Account
Number
Number | | Amount
Due | | | -------------------------------------- | --- | ------------- | --- | | | | USD 844.44 | | SP 01 000001 97702 A 1 ASNGLP NYSG LLC 457 MADISON AVE NEW YORK NY 10022-6843 I I I I 11..1.11 FedEx P.O. Box 371461 Pittsburgh PA 15250-7461 ![](_page_1_Picture_0.jpeg) | Invoice Number: | | | --------------- | ----------- | | Invoice Date: | Aug 26.2005 | | Account Number: | | | Page: | 2 of 3 | # Adjustment Request FAX TO (800) 548-3020 | Tracking NoAirbill No.
Explanation
Reason Code | | | ------------------------------------------------------------------------------------------------- | --------------------------------------------------------------- | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Flf FORE YOU FAX | | | | REASON CODE KEY
Reason | | Please kiclude detailed explanation for each adjustment request. | Description
Code | | Remember to include recipient's account number or third party's | Duplicate Eking
DUP | | account number if applicable. | PND
Shipment Never Sent
Incorrect Rates or Pieces
RATE | | | RRA
Rebill Recipient - Include | | From: | Recipient's Account No. | | | RSA
Rebill Sender | | | Rebill Thit Party - Include
RTA | | Name
Date | Third Party's Account No. | | | Incorrect Surcharge -
SUR
Please Explain | | | Other - Please Explain
OTHR | | 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
❑ Malting Address | | Account Number: | | | Name: | | | Address: | Apt. r Suite: | | City: | Zp | | Phone ( | | | Authorizing Sgnatute: | | ![](_page_2_Picture_0.jpeg) ### Invoice Number: Invoice Date: Aug 26, 2005 Account Number: Page: 3 of 3 FedEx Express Shipment Detail By Payor Type (Original) | Picked up: Aug 18, 2005 | | Payor: Shipper | Reference: NO REFERENCE INFORMATION | | | ----------------------- | -------------------------------- | ------------------------------------------------------------------------------- | ----------------------------------- | ------ | | | | Fuel Surcharge - FedEx has applied a fuel surcharge of 12.50% to this shipment. | | | | Tracking ID | | Sender | Recipient | | | | Service Type FedEx Intl Priority | LAUREN KWINTNER | JAMES CASNER | | | | Package Type FedEx Envelope | NYSG LLC | STRYKER DUEASING, GASNER, DOLLUS | | | Zone | | 457 MADISON AVE | | | | Orig./Dest | JRB/STT | NEW YORK NY 10022-6843 US | ST. THOMAS 00804 VI | | | Packages | | | | | | Weight | 0.5 lbs | Transportation Charge | | 31.50 | | Delivered | Aug 19, 2005 14:48 | Fuel Surcharge | | 2.47 | | Signed by | M.BETHUNE | Discount | | -11.75 | | Customs | | Total Transportation Charges | USD \$ | 22.22 | | Entry Date | Aug 19, 2005 | | | | | FedEx Use | G6167/US010/ | | | | | Picked up: Aug 22, 2005 | | Payor: Shipper | Reference: NO REFERENCE INFORMATION | | | | -------------------------------------------------------- | ------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------ | ----------------------------------------------------------------------------------- | ----------------------- | --- | | | Fuel Surcharge - FedEx has applied a fuel surcharge of 12.50% to this shipment. | | | | | | Tracking ID
Zone
Orig./Dest.
Packages
Weight | Service Type FedEx Intl Priority
Package Type FedEx Envelope
JRB/STT
0.5 lbs | Sender
LAUIR KWINTNER
NYSG LLC
457 MADISON AVE
NEW YORK NY 10022-6843 US | Recipient
JAMES COSNER
STRYKER DUENNING CARNER DELLISON
ST THOMAS 00804 VI | | | | Delivered
Signed by | Aug 23, 2005 14:17
M.BETHUNE | Transportation Charge
Fuel Surcharge
Discount | | 31.50
2.47
-11.75 | | | Customs
Entry Date
FedEx Use | Aug 23, 2005
G4885/US010/ | Total Transportation Charges | USD \$ | 22.22 | | | | | Shipment Detail Subtotal | | 44.44 | |