Form.jotform.com201087293839059CUSTOMER STATEMENT OF DISPUTED TRANSACTION 2025

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The document is a 'Customer Statement of Disputed Transaction' form that allows customers to report and dispute unauthorized transactions or issues related to their accounts. It includes sections for various types of disputes, such as unauthorized charges, ATM cash not received, incorrect transaction amounts, canceled transactions, defective merchandise, duplicate transactions, and non-receipt of goods or services. Customers are instructed to complete one section per dispute and provide supporting documentation before submitting the form via fax or email.

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