Customer Dispute Request form 513 Submit customer dispute information 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Card Number and the Date your account was hot carded. This information is crucial for identifying your account.
3. Fill in your Cardholder Name and Address to ensure proper identification and correspondence.
4. Provide the Date of your last valid transaction, which helps in processing your dispute effectively.
5. In the Disputed Transaction section, enter the Date, Dollar Amount, and Merchant Name related to the transaction you are disputing.
6. Indicate whether you have attempted to resolve this dispute with the merchant by checking 'Yes' or 'No'. If 'Yes', include details of your attempt.
7. Select one category that best describes your dispute from options like Unauthorized, Double billing, or Merchandise not received. Provide any additional details as required.
8. Finally, sign and date the form at the bottom before submitting it through our platform for processing.

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