Request for Disputed Invoice Information

To: {Name}
      {Address}
      {City, State, Zip}

Dear {Recipient},

This letter is to notify you that we recently received an {invoice/statement} with the number {number}, and dated {date}, in the amount of {amount}.

We believe this {invoice/statement} to be incorrect because {reason why you are disputing this invoice}.

We would like to resolve this issue as quickly as possible, but in order to do so, we need the following information from you: {copies of charges, list of shipped goods, etc.}.

Thank you,

{Sender}