Cardholder Dispute Form

CARD RULES GOVERNING THESE DISPUTES REQUIRE THAT YOU ATTEMPT TO RESOLVE YOUR DISPUTE WITH THE MERCHANT BEFORE COMPLETING THIS FORM. YOU MUST INCLUDE THE EVIDENCE OF YOUR ATTEMPT AND A DETAILED ACCOUNT OF THE SITUATION AS TO WHY THE MERCHANT WAS UNWILLING OR UNABLE TO RESOLVE THE ISSUE.

 

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Dispute Type
Please check the appropriate box above that matches your dispute type the closest. Return this form and any supporting documents so that your dispute can be processed in a timely manner. Please answer all appropriate questions below.
Did you cancel the merchandise or service prior to delivery
Was the merchandise delivered late or to the wrong address