Debit Memo format

June 24, 2011

A debit memo is used by a supplier. It is normally used to correct an error in a debited amount to show how much money is owed to the supplier by the customer. It lets the client know the amount of money owed and the exact number of items they are being charged for. A debit memo is usually issued as a result of a customer complaint. A sample debit memo format is shown below.

Sample Memo Format

Company logo: __________________________________

Name of Company: _________________________________

Address: __________________________________________

Telephone: _________________________________________

E-mail: ____________________________________________

Website: ___________________________________________

Receipt no: __________________________________________

Credit note no: ________________________________________

Customer no: ___________________________________________

Date: __________________________________________________


Customer’s name: ______________________________

Telephone number: _____________________________

E-mail: ______________________________________

Address: ______________________________________

Amount of money owed: _______________________________________

Reason for refund: _________________________________________________


Items    Quantities   Amount

_____________________ ___________ __________

Terms of shipment: _______________________________


Prepared by: _____________________________________

Signature: _____________________________________

Date: _________________

Download Debit Memo format in Word Format


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