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Customer Statementof Disputed TransactionPlease complete either Section 1 or Section 2 below. Use a separate form or additional pages to document each disputed transaction. Select form of delivery:
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Transaction dispute written claimpdfcredit is a formal document submitted to dispute a charge on a credit card or bank statement, seeking a resolution or a refund.
Any consumer or merchant who believes there has been an error or unauthorized transaction on their account may be required to file this claim.
To fill out the claim, provide details such as your account information, the transaction in question, the reason for the dispute, and any supporting documents.
The purpose is to formally address and resolve discrepancies or unauthorized transactions, ensuring consumers are protected against erroneous charges.
Key information includes the date of the transaction, transaction amount, merchant name, reason for the dispute, and contact information.
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