When cardholders face unexplained or unauthorized transactions on their credit cards, the CIMB Bank Dispute Declaration form serves as a critical tool for addressing such concerns. Tailored to provide a detailed avenue for customers to contest questionable transactions, the form is a gateway to potentially rectifying financial discrepancies that appear on one’s statement. Customers are required to furnish specifics like their name, credit card number, and details regarding the disputed transactions, which includes the merchant's name, the date of the transaction, and the amount in Singapore Dollars (SGD). The form categorically allows individuals to pinpoint the nature of their dispute, ranging from unauthorized transactions, duplicate billings, cancellations not recognized by vendors, to issues involving lost or stolen cards, among others. Additionally, it obliges customers to support their claims with pertinent documentation such as merchant acknowledgments, police reports for lost or stolen cards, and proof of alternate payments. Acknowledging the completion of this document binds the cardholder to the terms stipulated in the bank's cardmember agreement, including a retrieval fee if the dispute is resolved in favor of the transaction’s authenticity. This form, which must be submitted within a specific timeframe, underscores CIMB Bank's commitment to addressing customer grievances while also emphasizing the responsibility of cardholders to substantiate their disputes accurately and comprehensively.
| Question | Answer |
|---|---|
| Form Name | Cimb Bank Dispute Declaration Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | cimb form download, dispute form cimb, cimb bank declaration, dispute declaration form |
Strictly Private and Confidential
To: The Officer in Charge
Credit Cards & Personal Financing (ECO)
Robinson Road
P. O. Box 0088
Singapore 900138
Cardholder Name: |
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Credit Card No.: |
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DISPUTE DECLARATION FORM
Customer Hotline Number: +65 6333 6666
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No. |
Merchant Name |
Transaction Date |
Amount (SGD) |
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1.
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3.
4.
5.
Please tick ✓ one category that best describe your reason for disputing the transaction(s).
I did not authorize or participate in the above transaction(s) and the card was in my possession at time of the said transaction(s).
I did authorize and participate in the transaction for SGD |
at |
(merchant) but |
did not participate in the other transactions(s) and my card was in my possession at time of the other transactions(s). |
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I had only authorized one transaction. The above transactions(s) is/are duplicate(s)
I have notified the merchant to cancel the recurring membership/subscription on |
(date). Enclosed is the merchant |
acknowledgement on the cancellation. |
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The same transaction(s) was/were paid by other means. Enclosed is my proof of payment.
I have cancelled the hotel reservation. Enclosed is the hotel’s cancellation confirmation.
I have not received the merchandise and the expected date of delivery was |
. Enclosed is the confirmation stating the |
expected date of delivery. |
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I would like to request a copy of the sales draft for own reference and understand a retrieval fee of SGD$5.00 is applicable.
My Credit Card was lost/stolen on |
(date) and at |
(time). Enclosed is the police report for reference. |
Others (Please provide additional information)
I hereby confirm that the above informations are true and accurate. I acknowledge and agree that I am bound by the terms and conditions of CIMB Bank’s Cardmember’s agreement. I agree to bear the retrieval fee of S$5.00 each if transactions are found to be genuine.
Signature of Cardholder
Name as per NRIC/Passport:
NRIC/Passport No.:
Contact No.:
Date:
Note: Please return the completed form to us within 14 days from the statement date of the disputed transaction.
Thank you for banking with CIMB Bank. |
CIMB Bank Berhad |
V2020 APR |
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