Credit Card Services: Dispute Transaction form


Return Address of Cardholder:
First Name:	Last Name:
Department:
Campus Address:
City:	State: Zip:

Card Number:	Last 4 digits
Merchant Name:
Amount:
Transaction Date:
Reference Number:

To assist our investigation, please indicate below the reason for you dispute. If you have any question, call the JPMorgan Chase Dispute Representatives at (888) 297-0768.


	I did not make nor authorize the above transaction. (Please indicate the whereabouts of your CMU Business Card)

	There is a difference in the amount I authorized and the amount I was billed. (A copy of your charge must be enclosed)

	I only transacted one charge and I was previously billed for this sales draft. (Date of previous charge )

	The above transaction is mine but I am disputing the transaction. (Please state your reasons why, in detail)

	Please send me a copy of the sales draft. (Your account will be charged $5.00 for each copy supplied)

	I have received a credit voucher for the above transaction, but it has not yet appeared on my account. (A copy of the credit voucher must be enclosed)

	My account has been charged for the above transaction, but I have not received this merchandise. The details of my attempt to resolve the dispute with the merchant and the merchant's response are indicated below.

	My account has been charged for the above transaction, but the merchandise has since been returned. (Please enclose a copy of your postal receipt)


	Signature: ________________________________ Date: _____________

Send completed form to:	Bank Card Services
	P.O. Box 2015
	Elgin, IL 60121-2015

OR Fax to:	(847) 931-8861


A copy should also be faxed to (989) 774-1069, attention: Chris Zalud

Cardholder, MasterCard Disputed / Questioned Item on JPMorgan Chase Statement

Cardholder, MasterCard Disputed / Questioned Item
on JPMorgan Chase Statement