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Print Form Notification of Disputed Transaction Cancelled Service / Merchandise, Merchandise / Services Not Received Member Name: Debit Card Number: Transaction Date Settlement Date Merchant Name
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How to fill out notification of disputed transaction

How to fill out a notification of disputed transaction:
01
Gather all relevant information: Start by collecting all the necessary details about the disputed transaction. This includes the date of the transaction, the name of the merchant or company involved, the amount charged, and any supporting documentation such as receipts or invoices.
02
Review your account statement: Before proceeding with the notification, double-check your account statement to ensure that the transaction is indeed disputed. Look for any discrepancies or inaccuracies that may have caused the dispute.
03
Contact the financial institution: Get in touch with your bank or credit card company that issued the card used for the transaction. Inform them about the disputed transaction and express your desire to file a notification. They will guide you through the process and provide you with the necessary forms.
04
Fill out the notification form: Carefully complete all the required fields on the notification form. These typically include your personal details, account information, a description of the disputed transaction, and any additional comments or explanations you might have.
05
Include supporting evidence: Attach any supporting evidence you have to strengthen your case. This could include receipts, emails, invoices, or any other relevant documents that prove your claim.
06
Provide a clear and concise explanation: In the provided section, explain the reason why you are disputing the transaction. Be specific and provide as much detail as possible to help the financial institution understand your concerns.
07
Submit the notification: Once you have filled out the form, review it for any errors or missing information. Make sure everything is accurate and then submit the notification according to the instructions provided by your financial institution.
Who needs notification of disputed transaction?
01
Customers: Any individual who finds an unauthorized or suspicious transaction on their bank statement or credit card bill should file a notification of disputed transaction. This will initiate the process of investigating and resolving the issue.
02
Merchants: In some cases, merchants may also need to file a notification of disputed transaction. This can occur when they receive a chargeback or dispute claim from a customer. They are required to respond to the notification promptly and provide any necessary supporting documentation.
03
Financial institutions: Banks, credit card companies, and other financial institutions play a crucial role in managing and resolving disputed transactions. They receive and process the notifications, investigate the claims, and make a final determination regarding the validity of the transaction.
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