Debit Card Dispute

• Name of person disputing the transaction(s)?
  OK Name of person disputing the transaction(s)? is required
• Debit Card Number used in disputing transactions?
  OK Debit Card Number used in disputing transactions? is required

• Contact number of person disputing the transaction

  - -
  Optional OK Contact number of person disputing the transaction is required

• Did the cardholder authorize the transaction(s)?

  • No
  • Yes
  OK Did the cardholder authorize the transaction(s)? is required

• When did the cardholder notice the unauthorized transaction(s)

  JanFebMarAprMayJunJulAugSepOctNovDec 12345678910111213141516171819202122232425262728293031 20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900
  OK When did the cardholder notice the unauthorized transaction(s) is required

• Has the cardholder given anyone permission to use their card?

  • No
  • Yes
  OK Has the cardholder given anyone permission to use their card? is required
• If Yes, please explain
  Optional OK If Yes, please explain is required

• Has the cardholder contacted the merchant(s) about the transaction(s)?

  • No
  • Yes
  OK Has the cardholder contacted the merchant(s) about the transaction(s)? is required
• If Yes, what was the merchant's response?
  Optional OK If Yes, what was the merchant's response? is required
• Please explain why you are disputing these transaction(s)
  Optional OK Please explain why you are disputing these transaction(s) is required

Transaction 1

• Date

  JanFebMarAprMayJunJulAugSepOctNovDec 12345678910111213141516171819202122232425262728293031 20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900
  OK Date is required
• Amount
  $00.00 OK Amount is required
• Merchant Name
  OK Merchant Name is required

Transaction 2

• Date

  JanFebMarAprMayJunJulAugSepOctNovDec 12345678910111213141516171819202122232425262728293031 20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900
  Optional OK Date is required
• Amount
  Optional OK Amount is required
• Merchant Name
  Optional OK Merchant Name is required

Transaction 3

• Date

  JanFebMarAprMayJunJulAugSepOctNovDec 12345678910111213141516171819202122232425262728293031 20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900
  Optional OK Date is required
• Amount
  Optional OK Amount is required
• Merchant Name
  Optional OK Merchant Name is required

Transaction 4

• Date

  JanFebMarAprMayJunJulAugSepOctNovDec 12345678910111213141516171819202122232425262728293031 20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900
  Optional OK Date is required
• Amount
  Optional OK Amount is required
• Merchant Name
  Optional OK Merchant Name is required

Transaction 5

• Date

  JanFebMarAprMayJunJulAugSepOctNovDec 12345678910111213141516171819202122232425262728293031 20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900
  Optional OK Date is required
• Amount
  Optional OK Amount is required
• Merchant Name
  Optional OK Merchant Name is required

Transaction 6

• Date

  JanFebMarAprMayJunJulAugSepOctNovDec 12345678910111213141516171819202122232425262728293031 20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900
  Optional OK Date is required
• Amount
  Optional OK Amount is required
• Merchant Name
  Optional OK Merchant Name is required

Transaction 7

• Date

  JanFebMarAprMayJunJulAugSepOctNovDec 12345678910111213141516171819202122232425262728293031 20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900
  Optional OK Date is required
• Amount
  Optional OK Amount is required
• Merchant Name
  Optional OK Merchant Name is required

Transaction 8

• Date

  JanFebMarAprMayJunJulAugSepOctNovDec 12345678910111213141516171819202122232425262728293031 20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900
  Optional OK Date is required
• Amount
  Optional OK Amount is required
• Merchant Name
  Optional OK Merchant Name is required

By clicking “Submit”, you attest that the transactions detailed above were not made or authorized by you or another person that you authorized to use your card. In addition, you attest that you received no benefit from the transactions being disputed. You give consent to WinSouth CU to release any information regarding your card and/or card account to any federal, state, or local law enforcement agency so that the information can, if necessary, be used in the investigation and/or prosecution of any person(s) who may be responsible for fraud involving your card. You acknowledge that our investigation process is described fully for your reference in the agreement governing your account.
• OK is required