{
  "document_metadata": {
    "page_number": "2",
    "document_number": "4-495-86910",
    "date": "Dec 23, 2002",
    "document_type": "Adjustment Request",
    "has_handwriting": false,
    "has_stamps": false
  },
  "full_text": "FedEx Adjustment Request FAX TO (800) 548-3020 Invoice Number: 4-495-86910 Invoice Date: Dec 23, 2002 Account Number: 1144-2081-6 Page: 2 of 10 Tracking No./Airbill No. Reason Code Explanation BEFORE YOU FAX Please include detailed explanation for each adjustment request. Remember to include recipient's account number or third party's account number if applicable. From: Name ( ) Business Phone ( ) Date Business Fax REASON CODE KEY Reason Code Description DUP Duplicate Billing PND Shipment Never Sent RATE Incorrect Rates or Pieces RRA Rebill Recipient - Include Recipient's Account No. RSA Rebill Sender RTA Rebill Third Party - Include Third Party's Account No. SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain 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.fedex.com or register for FIO. FedEx Federal Express Please indicate change in address for the account # listed below Physical Address Billing Address Mailing Address Account Number 1144-2081-6 Name: Address: Apt. / Suite: City: State: Zip: Phone: ( ) Fax: ( ) Authorizing Signature: CONFIDENTIAL SDNY_GM_00340826 144 DOJ-OGR-00015453",
  "text_blocks": [
    {
      "type": "printed",
      "content": "FedEx Adjustment Request FAX TO (800) 548-3020",
      "position": "header"
    },
    {
      "type": "printed",
      "content": "Invoice Number: 4-495-86910 Invoice Date: Dec 23, 2002 Account Number: 1144-2081-6 Page: 2 of 10",
      "position": "header"
    },
    {
      "type": "printed",
      "content": "Tracking No./Airbill No. Reason Code Explanation",
      "position": "top"
    },
    {
      "type": "printed",
      "content": "BEFORE YOU FAX Please include detailed explanation for each adjustment request. Remember to include recipient's account number or third party's account number if applicable.",
      "position": "middle"
    },
    {
      "type": "printed",
      "content": "REASON CODE KEY Reason Code Description DUP Duplicate Billing PND Shipment Never Sent RATE Incorrect Rates or Pieces RRA Rebill Recipient - Include Recipient's Account No. RSA Rebill Sender RTA Rebill Third Party - Include Third Party's Account No. SUR Incorrect Surcharge - Please Explain OTHR Other - Please Explain",
      "position": "middle"
    },
    {
      "type": "printed",
      "content": "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.fedex.com or register for FIO.",
      "position": "middle"
    },
    {
      "type": "printed",
      "content": "FedEx Federal Express Please indicate change in address for the account # listed below Physical Address Billing Address Mailing Address",
      "position": "bottom"
    },
    {
      "type": "printed",
      "content": "CONFIDENTIAL",
      "position": "footer"
    }
  ],
  "entities": {
    "people": [],
    "organizations": [
      "FedEx"
    ],
    "locations": [],
    "dates": [
      "Dec 23, 2002"
    ],
    "reference_numbers": [
      "4-495-86910",
      "1144-2081-6",
      "1-800-622-1147",
      "SDNY_GM_00340826",
      "DOJ-OGR-00015453"
    ]
  },
  "additional_notes": "The document is a FedEx Adjustment Request form, page 2 of 10, dated Dec 23, 2002. It contains fields for tracking numbers, reason codes, and explanations for adjustments. The form also includes a section for changing the account address and a confidentiality notice at the bottom."
}