Dispute On Credit Card Transaction(S)
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1DISPUTE FORM
To : Customer Service, Maybank Credit Card Centre
DISPUTE ON CREDIT CARD TRANSACTION(S)
Name
Old IC Number
New IC Number
-
-
Old Card Number
-
-
-
New Card Number
-
-
-
I/We hereby dispute the following transaction(s) (list charges individually below, or attach billing statement and indicate the
disputed items) :-
NO
TRANSACTION DESCRIPTION
STMT DATE
TRXN DATE
AMOUNT(RM)
T
O
T
A
L
Reason(s) for dispute and enclose supporting document(s) which are available :-
I/We request a Sales Draft copy for reference ( A fee of RM5.00 will be levied).
The above charge(s) was/were neither made nor authorised by me/supplementary cardholder. The card was in my
/supplementary cardholder’s posession at the time of the above transaction.
I/We participated ____(times) transaction(s) amounting ___________but was/were billed ________(amount) for
_______(times).
Amount charged differs. I/We authorised _________(amount) but amount debited was ________(amount). Proof
enclosed.
I/We has/have paid the charge by cash/cheque/other credit card. Proof enclosed.
I/We have not received the merchandise/service for the transaction billed above. The expected delivery of
merchandise/service was __________________(mm/dd/yy).
I/We have cancelled the above transaction on __________(date). Proof of cancellation is enclosed.
Credit voucher issued by the merchant was not posted into my/supplementary cardholder’s account. Copy
enclosed.
I/We cancelled the reservation with the above hotel on _________(mm/dd/yy) and the cancellation code is
________________.
Others(please specify) ____________________________________________________________
Signed :
Declaration :-
(a) I/We did not use the above MAYBANK Credit Card for the listed transaction(s).
(b) I/We neither made nor authorised the listed transaction(s).
(c) I/We did not receive any benefit or value from this transaction(s).
Principal
(d) I/We did not receive the merchandise/services for the above listed transaction(s)
Tel/Fax :
(e) I/We understand that MAYBANK investigates fraudulent/unauthorised credit card
Date :
usage and may refer the matter to the appropriate law enforcement authorities.
Supplementary
Tel/Fax :
Date :
• •
The form must be duly signed & proof of cancellation is required.
For submission, please fax this form to 03-2026 9824 or mail it to Maybank Credit Card Centre, Customer Service
th
7
Floor Menara Maybank, 100 Jalan Tun Perak, 50050 Kuala Lumpur.
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Parent category: Financial