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CAUTION: Please only enter information required for your query, do not provide any unnecessary sensitive data via webforms or attachments.
Supplier name
Supplier number
Contact email
Confirm contact email NOTE: Please only enter ONE email address. Additional text submitted in this field may cause your case generation to fail, please only enter a valid email format.
Contact name
Debit note number NOTE: Please ensure a valid debit note number is provided, this should start with the letter D
Confirm debit note number
Debit value
Debit lines disputed: All debit lines Specific line number(s)
Please enter any specific line number(s)
Buyer Contact
Related case reference number
Signed POD & packing list NOTE: Please check the accepted file types in the file upload box above, your case will fail to generate if you attach a file type that is not accepted.
TIP: This form should be used to submit a dispute for ONE debit note. If you are disputing multiple debit notes, please raise one form for each debit note disputed.
IMPORTANT: If you do not receive a case reference number after submitting this form, please check the accepted file types listed in the file upload box above and resubmit your form. If you do not receive a case reference back, your dispute has not been logged and you will not receive a response back.