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CARDHOLDER INFORMATION

  • OK Name of person disputing the transaction(s) is required
  • OK Debit Card Number used in disputing transaction is required
  • Did the cardholder authorize the transaction(s)?

    OK Did the cardholder authorize the transaction(s)? is required
  • When did the cardholder notice the unathorized transaction(s)

    OK When did the cardholder notice the unathorized transaction(s) is required
  • Has the cardholder given anyone permission to use their card?

    OK Has the cardholder given anyone permission to use their card? is required
  • OK If Yes, please explain is required
  • Has the cardholder contacted the merchant(s) about the transaction(s)? (Contact with merchant must be attempted)

    OK Has the cardholder contacted the merchant(s) about the transaction(s)? (Contact with merchant must be attempted) is required
  • OK If Yes, please explain is required
  • Did the cardholder receive any service or merchandise from the transaction(s)?

    OK Did the cardholder receive any service or merchandise from the transaction(s)? is required
  • OK If Yes, please explain is required
  • Has the cardholder made any internet purchases in the last six months?

    OK Has the cardholder made any internet purchases in the last six months? is required
  • OK If Yes, please explain is required
  • OK Please explain why you are disputing these transaction(s) is required

Transaction 1

  • Date

    OK Date is required
  • OK Amount is required
  • OK Merchant Name is required

Transaction 2

  • Date

    Optional OK Date is required
  • Optional OK Amount is required
  • Optional OK Merchant Name is required

Transaction 3

  • Date

    Optional OK Date is required
  • Optional OK Amount is required
  • Optional OK Merchant Name is required

Transaction 4

  • Date

    OK Date is required
  • OK Amount is required
  • OK Merchant Name is required

Transaction 5

  • Date

    OK Date is required
  • OK Amount is required
  • OK Merchant Name is required

Transaction 6

  • Date

    OK Date is required
  • OK Amount is required
  • OK Merchant Name is required

    By clicking “Submit”, you attest that the transactions detailed above were not made or authorized by you or another person that you authorized to use your card. In addition, you attest that you received no benefit from the transactions being disputed. You give consent to FFCU to release any information regarding your card and/or card account to any federal, state, or local law enforcement agency so that the information can, if necessary, be used in the investigation and/or prosecution of any person(s) who may be responsible for fraud involving your card.

  • OK is required
  • Debit Card Dispute Notification