The Netspend Dispute Form is a crucial document designed to help cardholders report unauthorized credit or debit transactions on their accounts. By filling out this form, you initiate a formal dispute process, allowing Netspend to review the transactions in question and determine if you are eligible for a refund. It’s essential to act quickly, as you must submit the form within 60 days of the disputed transaction.
If you believe you have unauthorized charges on your account, don’t hesitate to take action. Click the button below to fill out the form and protect your financial interests.
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When disputing unauthorized transactions with Netspend, several additional forms and documents may be required to support your case. These documents help provide context and evidence for your claim, ensuring a smoother resolution process. Below is a list of commonly used forms and documents that can be submitted alongside the Netspend Dispute form.
Gathering these documents can enhance your dispute process, making it easier for Netspend to evaluate your claim. By providing comprehensive evidence, you increase the likelihood of a favorable outcome.
Dispute Notification Form - Unauthorized Credit/Debit Transactions
Please complete this Dispute Notification Form to initiate a dispute relating to any unauthorized credit or debit transactions on your card. This form must to be completed and submitted to Netspend as soon as possible, but no later than 60 days after the date of the transaction in dispute. A decision will be made regarding whether the funds in dispute will be credited to your card within 10 business days after our receipt of the completed Dispute Notification Form. Supporting documentation will assist in our determination.
Please keep in mind that if your card was lost or stolen or was used without your consent, you may be liable for any unauthorized use of your card. You will not be liable, however, for any unauthorized use that occurs after you have instructed us to block activity on your card. To instruct us to block activity on your card, please note in the appropriate place below that your card was lost or stolen. We also recommend that you reset your PIN and file a police report.
Cardholder Name: __________________ Phone Number: ________________
__________________________________________________________
Address City State Zip
Card or Account Number: __________________
Claim Number: _________
Please provide information for each
transaction you are disputing (submit up to 5
on one form)
Transactions
1
2
3
4
5
Disputed Amount
Date of Transaction (MM/DD/YY)
Time of Transaction (include AM or PM)
Merchant’s Name
Have you contacted the merchant? (Circle One)
Yes/No
- If yes, will they provide a refund? (Circle One)
- Date expected? (MM/DD/YY)
- Amount expected
Date card was noticed missing/lost/compromised: _____________ (MM/DD/YY)
Does anyone else have access to your PIN?
Yes
No
If yes, please explain how: ______________________________________________________
________________________________________________________________
Please provide a detailed explanation of what happened: (attach additional pages if needed)
Please sign and fax to: 512-531-8770
Include a full copy of the police report and any other supporting documents, i.e. receipts, emails, shipping or tracking information, contracts, cancellation information, when submitting this form.
___________________________ _______________
Card Holder Signature
Date
CH0006