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CHARGE BACK AUTHORITY FORM All credit card payments incur a 1.5% surcharge TO: FAX: DATE: COMPANY: FROM: PAGES: Please complete and return by email or fax. I of Name (as it appears on credit card)
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How to fill out charge back authority form

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How to Fill Out Charge Back Authority Form:

01
Obtain the charge back authority form from your bank or credit card issuer. They may have it available on their website or you can request it from their customer service team.
02
Carefully read through the instructions and requirements listed on the form. Make sure you understand what information is required and how it should be filled out.
03
Begin by providing your personal information, including your full name, contact details, and account number. Fill in any additional sections that ask for any other identification details.
04
Write a detailed explanation of the reason for the charge back. Clearly state the nature of the dispute or issue that led you to request a charge back. Provide any relevant supporting documents or evidence to support your claim.
05
Indicate the amount in dispute. This is the specific amount you are seeking to have refunded through the charge back process. Ensure that this amount matches the evidence and explanation you provided earlier.
06
Sign and date the form once you have filled in all the necessary information. Remember to read any terms or disclaimers included on the form before signing.
07
Submit the completed charge back authority form to the appropriate department or address listed on the form. Double-check that you have included all required documents and that you have made copies for your own records.
08
You may also consider sending a follow-up email or making a follow-up phone call to confirm that your charge back request has been received. This can help ensure that your claim is being processed and that any necessary additional information is provided promptly.

Who Needs Charge Back Authority Form:

01
People who have experienced unauthorized transactions on their credit or debit card statements may need a charge back authority form. This could include instances of fraud or identity theft.
02
Customers who have received defective or incorrect products could also require a charge back authority form to request a refund from the seller or merchant.
03
Individuals who have been charged for services not rendered or for canceled subscriptions may need to fill out a charge back authority form to dispute these charges and seek a refund.
04
In cases where a merchant has failed to deliver a promised product or service, customers may need to use a charge back authority form to recover their money.
05
Some banks or credit card issuers may require a charge back authority form as part of their formal dispute resolution process, even if the customer has verbally reported the issue. In this case, customers would need to fill out the form to initiate the charge back process.
06
It is advisable to check with your bank or credit card issuer's policies and guidelines to determine whether a charge back authority form is required in your specific situation. They will be able to provide you with the necessary information and forms, if needed.
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Charge back authority form is a document that authorizes a certain party to reverse a payment transaction.
Anyone who wants to dispute a transaction and request a charge back is required to file charge back authority form.
To fill out a charge back authority form, provide your personal information, details of the transaction, reasons for disputing the transaction, and any supporting documents.
The purpose of charge back authority form is to dispute a transaction and request a charge back on the payment.
The information reported on charge back authority form includes personal information, transaction details, reasons for disputing, and supporting documents.
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