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APPENDIX D CHARGE DISPUTE FORM The following item(s) listed on account statement is disputed for the following reason(s): Unauthorized charge Incorrect charge amount Multiple billing Merchandise returned

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How to fill out charge dispute form

How to fill out a charge dispute form:

01

Gather all relevant information: Before beginning the filling process, collect any necessary documents or evidence related to the disputed charge. This may include receipts, bank statements, or any other supporting documentation.

02

Identify the disputed charge: Clearly state the specific charge that you are disputing. Provide as much detail as possible, including the date, amount, and any related information such as the merchant or company name.

03

Explain the reason for the dispute: In this section, provide a detailed explanation of why you are disputing the charge. Be factual and concise, and include any relevant information or circumstances that led to the dispute.

04

Attach supporting documentation: If you have any evidence or supporting documents that can help to substantiate your dispute, make sure to include them. This might include receipts, emails, or any other records that prove your claim.

05

Provide contact information: Make sure to include your full name, address, phone number, and email address. This will ensure that the company or institution handling the dispute can get in touch with you if they require any further information.

06

Sign and date the form: Once you have filled out all the necessary sections of the dispute form, review it for accuracy and completeness. Make sure you have signed and dated the form before submitting it.

Who needs a charge dispute form:

01

Customers who have experienced unauthorized charges: If you notice any charges on your account that you did not authorize or recognize, you may need a charge dispute form to report the issue to your bank or credit card company.

02

Individuals who have received faulty or damaged products: If you received a product that is faulty, damaged, or significantly different from what you ordered and the merchant is not addressing the issue, a charge dispute form may be necessary to seek a refund or resolution.

03

Customers who have been overcharged or charged incorrectly: If you believe you have been charged more than the agreed-upon amount or have been charged for a service you did not receive, a charge dispute form can help rectify the situation.

04

Individuals who have experienced fraudulent activity: If you suspect that someone has obtained your credit card information and used it to make unauthorized purchases, a charge dispute form can initiate an investigation and potentially protect you from financial loss.

Overall, a charge dispute form provides a structured way to address and resolve any discrepancies or issues related to charges on your accounts. It is important to fill out the form accurately and provide any necessary supporting documentation to increase the chances of a successful resolution.

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What is charge dispute form?

The charge dispute form is a document used to dispute a charge or fee on a bill or account.

Who is required to file charge dispute form?

Any individual or entity that believes there is an error in the charges on their bill or account is required to file a charge dispute form.

How to fill out charge dispute form?

To fill out a charge dispute form, one must provide their personal information, details of the disputed charge, and any supporting documentation.

What is the purpose of charge dispute form?

The purpose of a charge dispute form is to formally contest and investigate inaccuracies in charges on a bill or account.

What information must be reported on charge dispute form?

The charge dispute form must include details of the disputed charge, any relevant dates, account information, and contact information.

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