Get the free Statement of Unauthorized Debit - Synergy Federal Credit Union - synergyfcu

Synergy Federal Credit Union Written Statement of Unauthorized Debit (ACH) 1. Account / Transaction Information Name: Account Number: Amount of Debit: Date of Debit: Party Debiting the Account: 2.

How to fill out statement of unauthorized debit

How to fill out statement of unauthorized debit:

1. Start by gathering all relevant information about the unauthorized debit. This includes the date, amount, and description of the transaction, as well as any supporting documents or evidence.
2. Contact your bank or financial institution immediately to report the unauthorized debit. Inform them that you need to fill out a statement of unauthorized debit and request the necessary form.
3. Obtain the statement of unauthorized debit form from your bank. This form is typically provided by the bank and may also be available on their website.
4. Carefully read and understand the instructions on the form before proceeding. Ensure that you have all the required information and documents ready.
5. Begin filling out the form by providing your personal information, such as your name, address, contact details, and account number.
6. Specify the unauthorized transaction by entering the relevant details, such as the date, amount, and description of the debit.
7. Include any supporting documents or evidence that you have, such as receipts, bank statements, or communication with the merchant involved.
8. Describe in detail why you believe the debit was unauthorized. Provide any additional information that may support your claim, such as if your card was lost or stolen, or if you suspect fraudulent activity.
9. Sign and date the statement of unauthorized debit form. Double-check all the information you have provided to ensure its accuracy.
10. Submit the completed form to your bank or financial institution as per their instructions. Follow up with them to ensure that they have received your statement and to inquire about the next steps.

Who needs statement of unauthorized debit:

1. Individuals who have experienced an unauthorized debit on their bank account or credit card.
2. Anyone who believes they have been a victim of fraud or identity theft.
3. Customers who want to dispute a specific transaction and seek reimbursement for the unauthorized debit.

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What is statement of unauthorized debit?

Statement of unauthorized debit is a form used to report any unauthorized transactions on a bank account.

Who is required to file statement of unauthorized debit?

Account holders who notice unauthorized transactions on their bank accounts are required to file a statement of unauthorized debit.

How to fill out statement of unauthorized debit?

To fill out a statement of unauthorized debit, account holders need to provide details of the unauthorized transactions, including date, amount, and description.

What is the purpose of statement of unauthorized debit?

The purpose of statement of unauthorized debit is to notify the bank of any unauthorized transactions on a bank account and to request a refund.

What information must be reported on statement of unauthorized debit?

Information such as date, amount, description, and any supporting documentation related to the unauthorized transactions must be reported on the statement of unauthorized debit.