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Cardholder Dispute Fraudulent TransactionsThis affidavit is for the purpose of establishing the fraudulent use of your Visa Check Card or ATM card. All other disputes must be filed using the form
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This affidavit is for confirming certain information to be true and accurate.
Any individual or entity specified in the instructions.
Follow the instructions provided and fill in all required fields accurately.
The purpose is to certify the accuracy of the information provided.
Any information specified in the form or instructions.
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