Netspend Dispute Form PDF 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.

Form NameNetspend Dispute Form
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namesdispute documents netspend email, netspend dispute, dispute documents netspend all access, netspend login

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)

















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)









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









- 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?



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



How to Edit Netspend Dispute Form Online for Free

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Put down the data in the If yes please explain how, Please provide a detailed, Please sign and fax to Include a, Card Holder Signature, and Date area.

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