Transaction Dispute Investigation

Transaction Dispute Request

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Your Details

Member Number *

Full Name *

Preferred Contact Number *

Email Address *

Transaction Type *VisaATMEFTPOSBPAYOSKOFunds Transfer

VISA Transaction Details

Card Number (first 4 digits) *

Card Number (last 4 digits) *

Date of Transaction 1 *

Merchant Name *

Amount *

AUD

Date of Transaction 2

Merchant Name

Amount

AUD

Date of Transaction 3

Merchant Name

Amount

AUD

Do you have more disputed transactions?NoYes

Date of Transaction 4

Merchant Name

Amount

AUD

Date of Transaction 5

Merchant Name

Amount

AUD

Date of Transaction 6

Merchant Name

Amount

AUD

Do you have more disputed transactions?NoYes

If so, please email them to [email protected]

Dispute ReasonUnauthorised Transaction - Transaction not authorised by Primary or Additional cardholder. The card was in my possession at the time of the transaction. Note: The card will be cancelled and a replacement card will be issued (subject to replacement card eligibility policy)Duplicate Billing - I was charged more than once for a single authorised transaction. I have not authorised the other transaction(s). My card was in my possession at the time of the transaction.Non-Receipt of GoodsRefund/Credit not Processed - Credit transaction receipt issued but credit not processed to my account.Goods returned to Merchant but Refund not Processed.Cancelled Membership/SubscriptionPaid by other means - The transaction was charged to my account and was also paid by other means.Incorrect Amount ChargedServices not Rendered - Services for the transaction(s) were not rendered due to the inability/unwillingness of the merchant. I have attempted to resolve this dispute with the merchant and/or merchant’s liquidator.Cancelled Accommodation - Accommodation was booked and cancelled within cancellation policy.Other - If your dispute does not fall into any of the above categories, please provide a detailed explanation of the circumstances surrounding your dispute below.Select one option

If Other, please provide details

Where did you use the card? *Over the phone or internetAt a physical locationPlease select one option

Was this transaction authorised by yourself?YesNoPlease be aware some merchants may appear under a different name on your statement.

Have you (or someone you know) used your card for access to any mobile phone programs or gaming consoles?YesNoA subscription may be set up for add-ons to games, e.g. Apple, Xbox, Microsoft

Notes

Please contact the merchant prior to lodging a dispute - we may not be able to lodge these on your behalf
Any PayPal transactions need to be disputed through PayPal themselves as they have their own dispute resolution
- Please contact PayPal directly - we are NOT able to lodge these on your behalf

Did you provide any extra verification details?YesNoe.g. Date of birth, pet's name or CVV (3 digits on back of card)

Did you sign up for a Free Trial or similar offer?YesNo

If Yes, please attach any correspondence with the merchant alongside dates of the order and the cancellation.

Have you attempted to contact the merchant to cancel your subscription?YesNo

If No, please contact the merchant prior to lodging a dispute.

Card used at a Physical Location

Has your card been Lost or Stolen (if not authorised by yourself)?YesNoIf either of these apply, First Option will stop your card and issue a new one (delivery of new card is 7-10 days).

How did you pay?payWave (Tap & Pay)Insert Card with chip and entered PINSwipe magnetic strip and entered PINSignatureSelect one option

BPAY Transaction Details

Transaction 1

Account Number

Transaction Date

Amount

AUD

Biller Name

Receipt Number

Transaction 2

Account Number

Transaction Date

Amount

AUD

Biller Name

Receipt Number

Funds Transfer Details

Account Number

Transaction Date

Amount

AUD

Recipient BSB

Recipient Account Number

Recipient Account Name

Osko Details

Account Number

Recipient PayID or Account Number

Transaction Date

Amount

AUD

ATM Transaction Details

Account Number

Card Number (Last 4 Digits)

Amount

AUD

Transaction Date

ATM Location

Transaction Type

Did the ATM Malfunction?YesNo

Amount Requested

AUD

Amount Received

AUD

Was your card captured?YesNo

Was the transaction authorised?YesNo

Is the card in your possession?YesNo

Have you previously reported the card as lost or stolen?YesNo

Who did you report it to?

Have you disclosed your PIN to anyone?YesNo

EFTPOS Dispute

Account Number

Card Number (Last 4 Digits)

Amount

AUD

Transaction Date

Transaction Type

Dispute Type

Upload Documents

Upload Documentation

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e.g. Receipt, letter, invoice, notice, etc.

Document 2 (if required)

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e.g. Receipt, letter, invoice, notice, etc.

Document 3 (if required)

No file chosen

e.g. Receipt, letter, invoice, notice, etc.

Document 4 (if required)

No file chosen

e.g. Receipt, letter, invoice, notice, etc.

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Transaction Dispute Request

Your Details

VISA Transaction Details

Card used at a Physical Location

BPAY Transaction Details

Funds Transfer Details

Osko Details

ATM Transaction Details

EFTPOS Dispute

Upload Documents

Resources

Assistance

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Transaction Dispute Request

Your Details

VISA Transaction Details

Card used at a Physical Location

BPAY Transaction Details

Funds Transfer Details

Osko Details

ATM Transaction Details

EFTPOS Dispute

Upload Documents

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