Who needs the Transaction Dispute Form/ Written Statement of Unauthorized Debit?
The given form is designed by the Green Dot Corporation, which is the US issuer of prepaid MasterCard and Visa cards. The form should be used by the company customers who assume having been charged for an unauthorized debit or transaction via the stated type of card.
What is the purpose of the Transaction Dispute Form/ Written Statement of Unauthorized Debit?
The primary purpose of the form is to notify the bank of the customer's wish to dispute a charge from the merchant that has posted to their card and to claim the chargeback. Via this form, the cardholder is supposed to provide all the required information about themselves and their card and to furnish all the data regarding the disputed transaction or transactions.
When is the Transaction Dispute Form/ Written Statement of Unauthorized Debit due?
It is highly recommended that the form is a relevant case be submitted as soon as the cardholder has become aware of such a transaction to be disputed. It typically, takes three days for a transaction to clear
Is the Dispute Form accompanied by any other documents?
To simplify the procedure of the claim consideration and processing it is necessary to provide sufficient supporting documents: receipts, invoices, correspondence with the merchant, etc.
How to fill out Transaction Dispute Form/ Written Statement of Unauthorized Debit?
The following details are to be indicated on a properly filled out form for transaction dispute:
- Name of the cardholder;
- Number of the card;
- Address and contact phone number;
- The transaction(s) data (amount and date, name of the merchant, whether they were contacted regarding the chargeback);
- Grounds for the dispute;
- Claim number;
- Signature of the cardholder.
Where to send the completed form?
The Transaction Dispute Form/ Written Statement of Unauthorized Debit must be submitted with cardholder’s bank.