Dispute Documents Details

Netspend Dispute Form is a form that you can use to help dispute charges on your Netspend card. The form will help you provide the necessary information to begin the dispute process. You can also use the form to track the progress of your dispute. Keep in mind that disputes may take up to 30 days to process, so be patient. If you have any questions about the dispute process, please call Netspend Customer Service at 1-866-387-7363.

Here's some specifics to help you determine the amount of time it will take to complete the netspend dispute form.

QuestionAnswer
Form NameNetspend Dispute Form
Form Length1 pages
Fillable?Yes
Fillable fields45
Avg. time to fill out9 min 19 sec
Other namesdispute documents, dispute documents skylight paycard com, netspend, disputedocuments netspend com

Form Preview Example

Dispute Notification Form - Unauthorized Credit/Debit Transactions

Please complete this Dispute Notification Form to initiate a dispute relating to any unauthorized credit or debit transactions on your card. This form must to be completed and submitted to Netspend as soon as possible, but no later than 60 days after the date of the transaction in dispute. A decision will be made regarding whether the funds in dispute will be credited to your card within 10 business days after our receipt of the completed Dispute Notification Form. Supporting documentation will assist in our determination.

Please keep in mind that if your card was lost or stolen or was used without your consent, you may be liable for any unauthorized use of your card. You will not be liable, however, for any unauthorized use that occurs after you have instructed us to block activity on your card. To instruct us to block activity on your card, please note in the appropriate place below that your card was lost or stolen. We also recommend that you reset your PIN and file a police report.

Cardholder Name: __________________ Phone Number: ________________

 

__________________________________________________________

 

 

Address City State Zip

 

 

 

 

 

 

 

Card or Account Number: __________________

Claim Number: _________

 

 

 

 

 

 

 

 

 

 

 

 

Please provide information for each

 

 

 

 

 

 

 

 

 

transaction you are disputing (submit up to 5

 

 

 

 

 

 

 

 

 

on one form)

 

 

 

 

Transactions

 

 

 

 

1

 

2

 

3

4

5

Disputed Amount

 

 

 

 

 

 

 

Date of Transaction (MM/DD/YY)

 

 

 

 

 

 

 

Time of Transaction (include AM or PM)

 

 

 

 

 

 

 

Merchant’s Name

 

 

 

 

 

 

 

Have you contacted the merchant? (Circle One)

Yes/No

 

Yes/No

 

Yes/No

Yes/No

Yes/No

 

- If yes, will they provide a refund? (Circle One)

Yes/No

 

Yes/No

 

Yes/No

Yes/No

Yes/No

 

- Date expected? (MM/DD/YY)

 

 

 

 

 

 

 

 

- Amount expected

 

 

 

 

 

 

 

Date card was noticed missing/lost/compromised: _____________ (MM/DD/YY)

Does anyone else have access to your PIN?

Yes

No

If yes, please explain how: ______________________________________________________

________________________________________________________________

Please provide a detailed explanation of what happened: (attach additional pages if needed)

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

Please sign and fax to: 512-531-8770

Include a full copy of the police report and any other supporting documents, i.e. receipts, emails, shipping or tracking information, contracts, cancellation information, when submitting this form.

___________________________ _______________

Card Holder Signature

Date

CH0006

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