Billing Appeal Form

If you have a question/concern about a Library Billing matter or you wish to appeal/contest a bill, please complete this form. A Library staff person will soon contact you.

First Name: *

Last Name: *

Library barcode number: *

Enter the number from your ID. Example: 22106007679833.

Phone:

Email address: *

Indicate the type of checkout: *

General Collection

Interlibrary Loan

Reserves

Media Center

For each item, please enter the TITLE, BARCODE and CALL NUMBER separated by commas. (ex. The Grapes of Wrath, 32106014060575, PS3537.T3234G8 1967)

NOTE: For ILL items, please include the TITLE and the ILL NUMBER located on the bookstrap or an overdue notice. (ex. The Grapes of Wrath, ILL: 5864795)

Item 1:

Item 2:

Item 3:

Item 4:

Item 5:

Item 6:

Item 7:

Item 8:

Item 9:

Item 10:

Item Status

Note: If you have more than one item and the status is different between the items, please use the Explanations/Comments area below.

Choose a reason below for appealing your bill:

I returned it on this date:

I question the amount of fees assessed: $

I need more info: (specify)

Explanation/comments: