Dealing with unauthorized transactions on your ICICI Bank account can trigger a whirlwind of stress, but thankfully, the Transaction Charge Back Form offers a clear path to dispute questionable charges. This crucial document is specifically designed for instances where transactions don't align with your approval or knowledge, effectively serving as a beacon for concerned account holders. Key features of the form require it to be completed with attention to detail, emphasizing the use of CAPITAL LETTERS and BLACK INK. It's divided into sections that cover everything from personal details to the nature of the dispute, including whether the problem arose from a lost or stolen card. The form also highlights the importance of ticking all relevant products affected by the disputed transactions, whether they're related to savings, eWallets, or physical or virtual credit cards. Moreover, the documentation checklist prompts users to attach supporting evidence like a copy of the FIR in cases of theft, reinforcing the gravity of these situations. A declaration section at the end seeks explicit consent from the customer for the bank to undertake any necessary investigations or legal actions. This not only underscores the bank's commitment to resolving such issues but also reassures customers about the structured process in place to protect their financial interests.
| Question | Answer |
|---|---|
| Form Name | Charge Back Form ICICI Bank |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 57 |
| Avg. time to fill out | 11 min 58 sec |
| Other names | icici bank charge dispute form online, customer dispute form icici, charge dispute form icici, customer dispute icicibank |
Transaction Charge Back Form For Disputed Transactions
To be filled in by the Bank Official:
Date of Receipt:
Officer Code:
FIELDS WITH * (STAR) ARE COMPULSORY. Please fill all the details in CAPITAL LETTERS and BLACK INK only.
To,
The Manager Operations,
b2 Banking,
ICICI Bank Ltd.,
Mumbai
Date:
I am disputing the transactions for the following product (Please tick the product for which you have the dispute)
b2 Savings Account No:
b2 eWallet No:
b2 Credit Card Account No:
b2 Virtual Credit Card No:
Service Request No:
Personal Details
*Customer Name:
Mr./ Ms./ Dr. |
Applicant Name |
Reason For Dispute
I am disputing the following transactions for the reasons below
I had lost my card on |
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charges are on the lost card. |
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I did not receive the card and I have not incurred or authorized these charges. ( Applicable only for Physical b2 Credit Card)
I have neither incurred nor authorized the below transactions, the card was always in my possession.
The card was stolen from me on |
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a.m./p.m. All charges were on the Stolen card. I am enclosing a copy of the FIR |
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filed with Police. |
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Details of Disputed Transactions
Transaction Date
Merchant Name
Transaction Amount
Additional Comments:
Document Check List (I have attached along with this application the following documents)
FIR Copy
Declaration (I have attached along with this application the following documents)
I hereby confirm that the information furnished above is true and to the best of my knowledge and I authorise you conduct Investigations and take legal actions against culprit if necessary.
Customer’s Signature
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