Axis Bank Dispute Form PDF Details

When it comes to managing finances, Axis Bank provides its customers with a safety net in the form of the Axis Bank Dispute Form. This crucial document is designed for cardholders who encounter discrepancies in their transactions, whether they be with a debit, credit, or forex card. The form serves as a formal request for the bank to resolve disputes that can range from unauthorized transactions, duplicate billings, undelivered goods or services, to incorrect transaction amounts, among others. Located at the heart of Airoli Knowledge Park, Navi Mumbai, the form necessitates the cardholder to meticulously list each disputed transaction by providing specific details like the transaction date, merchant name, amount, and reason for dispute. The form not only asks for a clear elucidation of the problem but also requires the submission of corresponding evidence like receipts, correspondence with the merchant, or any relevant documentation to fortify the claim. It embodies a declaration segment where the customer affirms the authenticity of the information provided, underlining the seriousness of false claims which could lead to legal repercussions. Through this formal complaint mechanism, Axis Bank ensures an avenue for redressal, underpinning its commitment to customer satisfaction and security.

QuestionAnswer
Form NameAxis Bank Dispute Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namescharge dispute form axis bank, customer dispute form axis bank, axis bank cardholder dispute form, ccrs form axis bank

Form Preview Example

Cardholder Dispute Form

To,

Axis Bank Ltd, NPC1, 5th Floor, "Gigaplex", Plot No I.T.5,

MIDC, Airoli Knowledge Park, Airoli, Navi Mumbai - 400708.

Fax no - 022 71315270

Axis Bank Customer

Cardholder’s Name Contact Number Email

Debit/Credit/Forex Card number** Axis Bank Account Number

(Applicable For Debit Cardholders only)

Yes No

S T D

Details of Disputed Transaction/s

Sr.

 

Transaction Date

Merchant Name/ATM Location

Transaction Amount & Currency

Disputed Amount & Currency

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I am disputing transaction/s listed above due to the following reasons. Request you to resolve the dispute.

Kindly () the issue as per applicable

Duplicate/multiple billing. I have done only one transaction but I was billed ______________ (Twice/Thrice etc).

The Goods/Services rendered by the Merchant are not as described. The item/s purchased or service/s paid for do not conform to what was agreed to have been supplied by the merchant or was defective. (Please specify as to what good/s or service/s were expected and what were actually delivered. Enclose any documentation that supports your claim. If you have returned the merchandise to the merchant, please provide us with proof of return, such as postal/courier receipt and correspondence with the merchant.)

I had tried transaction online, the same was not successful but the amount was debited from my account. Cash not dispensed in ATM but I was billed for the entire amount.

Less cash of ______________ (provide Amount & Currency) dispensed in the ATM but I was billed for the entire amount ______________

(provide Amount & Currency).

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).

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).

Cancelled membership/Subscription/booking (Attach the cancellation letter which you sent to the merchant).

I ordered goods/services and the same are expected by Date (dd/mmm/yyyy) ____________. But I never received the same.

(Correspondence with merchant for order status is required)

The transaction amount is ______________ (provide Amount & Currency) but I was billed for ______________ (provide Amount & Currency).

I have not participated or authorized the above transaction(s). The card was in my possession at all times. Hotel Reservation:

(A)I have cancelled the Reservation. The Cancellation Date being ______________ and the Cancellation Code is _________

(B)I have not made or authorized any reservation/s or availed of the services

Others (Please explain in detail. Please attach a separate letter if necessary) _____________________________________

**Request to the Cardholder: Please attach copies of your correspondence with the Merchant, charge-slips wherever applicable and any supplementary documents pertaining to the transaction/s, as appropriate.

Declaration

I hereby confirm that the averments made by me within this form are bona-fide and the information provided is true and accurate to the best of my knowledge and belief. In case this claim is determined by the Bank to be false or maliciously made, I shall be fully responsible for the consequences which may include civil/criminal lawsuit being initiated by the Bank.

Date

D D M M Y Y Y Y

Place ___________________________________________

Customer Signature

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step 1 to writing axis bank ccrs form

Write the necessary data in the The GoodsServices rendered by the, I had tried transaction online the, Cash not dispensed in ATM but I, Less cash of provide Amount, Transaction cancelled and I have, Paid by other means First I gave, Cancelled, I ordered goodsservices and the, The transaction amount is provide, I have not participated or, Hotel Reservation A I have, Others Please explain in detail, and Request to the Cardholder Please segment.

axis bank ccrs form The GoodsServices rendered by the, I had tried transaction online the, Cash not dispensed in ATM but I, Less cash of  provide Amount, Transaction cancelled and I have, Paid by other means First I gave, Cancelled, I ordered goodsservices and the, The transaction amount is  provide, I have not participated or, Hotel Reservation A I have, Others Please explain in detail, and Request to the Cardholder Please fields to fill

You need to emphasize the significant particulars within the Date D D M M Y Y Y Y, Place, and Customer Signature area.

Completing axis bank ccrs form part 3

Step 3: Hit the Done button to be sure that your finalized document can be transferred to any kind of gadget you end up picking or sent to an email you indicate.

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