Check Card and Credit Card Dispute Form - Denver CO - bellco 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your card number in the designated field. This should be the card number associated with the disputed charges.
  3. Fill in your name, member number, and address accurately to ensure proper identification.
  4. Provide your home and work phone numbers for any follow-up communication regarding your dispute.
  5. Indicate the transaction date and amounts for both the transaction and dispute in their respective fields.
  6. Specify the merchant's name where the disputed transaction occurred.
  7. Select one of the dispute reasons provided, such as 'Unrecognized Transaction' or 'Incorrect Amount', and provide detailed descriptions as required.
  8. Use the additional information section to elaborate on your attempts to resolve the issue with the merchant, attaching any necessary documentation.
  9. Finally, sign and date the form before submitting it via fax to ensure it is processed promptly.

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