Cleaning Services
Cost Resolution Form 

Please complete this form to document and request resolution for any discrepancies or issues related to service costs. Ensure all sections are filled out accurately to expedite the resolution process.

Date of Submission:                               

General Information

Date of Service		Invoice Number
Submitted By		Contact Info

Description of Cost Discrepancy

Description	Expected Cost	Actual Cost Charged

Supporting Documents

• Invoice

• Contract

• Other:                               

Desired Resolution

• Refund

• Adjustment

• Other:                               

Explanation

Acknowledgment

By submitting this form, I affirm that the information provided is accurate to the best of my knowledge and understand that additional documentation or discussion may be required to resolve the issue.

[Name]

[Date]

Cleaning Services Templates @ Template.net