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HDFC Dispute Form

The cardholder dispute form allows customers to dispute transactions on their credit or debit cards. It requests information about the disputed transaction such as date, merchant, and amount. The customer then selects a reason for disputing the transaction from a list including duplicate charges, paid by other means, incorrect amount, cancelled transactions, goods not received, ATM issues, and fraudulent transactions. The customer provides their signature and contact information and acknowledges a retrieval fee may be charged if the dispute is found to be invalid.

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Wasif
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141 views

HDFC Dispute Form

The cardholder dispute form allows customers to dispute transactions on their credit or debit cards. It requests information about the disputed transaction such as date, merchant, and amount. The customer then selects a reason for disputing the transaction from a list including duplicate charges, paid by other means, incorrect amount, cancelled transactions, goods not received, ATM issues, and fraudulent transactions. The customer provides their signature and contact information and acknowledges a retrieval fee may be charged if the dispute is found to be invalid.

Uploaded by

Wasif
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Cardholder Dispute Form

To
The Charge back unit, HDFC Bank,
O-2, I Think Techno Campus,
Near Kanjurmarg Station,
Kanjurmarg East, Mumbai 400042
Fax: 022-30751580.

Card Number

A/c Number

Details of disputed item/s:


Transaction Date Merchant Name/ATM Location Transaction Amt Disputed Amt

I am disputing the transaction(s)listed above for the below given reason and request you to settle the
cases. (Please  one)

*Credit with Hold Funds will be marked only for transaction’s done at Merchant locations for the below
disputes (Cases 1 to 6). If the aforesaid transaction(s) is deemed to be a valid transaction, Credit put
to your account with hold funds will be reversed and proof of transactions will be sent to you.

1. Duplicate/multiple billing. I have done only one transaction but I was billed ______(Twice/Thrice etc).
(#accepted transaction receipt)
2. Paid by other means. First I gave my card for payment and later on I changed my mind and paid by other
means like by cash (#attach cash receipt/bill)/Cheque(#attach cheque receipt/bank
statement)/other card (#attach chargeslip/other card statement ).
3. The transaction Amount is Rs__________but I was billed for Rs.__________ (#Attach customer copy of
chargeslip/sales slip).
4. Transaction cancelled and I have not received the credit/refund for the same (Attach credit slip/refund
note/merchant’s letter or any form of merchant’s confirmation that the transaction was cancelled and the
credit was due to you).
5. Cancelled membership/Subscription/booking (**Attach the cancellation letter which you sent to the merchant)
6. I ordered goods/services and the same are expected by Date ( dd/mm/yy)_________. But I never received
the same. ** I contacted the merchant on Date (dd/mm/yy) ________and his response _____
_____________________________________________________________________.
7. Cash not dispensed in the ATM but I was billed for the amount.
8. Received cash Rs.________ in the ATM but I was billed for the entire amount Rs_______.
9. I have not participated or authorised the above transaction(s). The card was in possession of mine at all times.
10. Others (Please explain in detail. Please attach a separate letter if necessary).
________________________________________________________________________________________
________________________________________________________________________________________

* Credit with hold funds will not be given for all disputes arising due to misuse and fraudulent usage on
cards being reported as stolen or lost.
**For Internet / E-commerce transactions, the customer needs to first contact the Merchant & attempt
to resolve the dispute.

Declaration: I hereby confirm that the information mentioned above is true and to the best of my knowledge.

Cardholder’s Name : Place :

Signature : Date :

Email : Landline / Mobile No :

Please note that a Retrieval Fee of Rs.100/- shall be charged per transaction to your account if the
disputed transaction turns out to be valid.

finotax.com

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