This is the general questionnaire structure for the response to /claim/intake/retrieveQuestionnaire
when the dispute is for a Visa and it is not fraud.
Note
This schema represents an example only. The actual questionnaire you get might vary from what is shown here.
I participated in this transaction, but there is a problem.
Which of the following best describes the reason for your dispute?
I have not received the merchandise or services that I purchased.
-
[required] Are you disputing the full amount of the transaction? [
Yes/No
]-
No —
-
What amount are you disputing? [
Text
] -
Why is the dispute different than the posted transaction amount? [
Text
]
-
-
Yes
-
-
[required] Is the purchase a third-party gift card without an expiration date, where the merchandise or services were not provided by the third party due to insolvency or bankruptcy? [
Yes/No
]-
No
-
Yes
-
-
[required] What was not received? [
BulletList
]
― Merchandise
-
[required] Did the merchant cancel the merchandise? [
Yes/No
]-
No
-
Yes —
-
Date merchant cancelled merchandise [
Date
] -
Is the merchant in bankruptcy or liquidation? [
Yes/No
]-
No
-
Yes
-
-
-
-
[required] Are you still expecting a delivery for the merchandise? [
Yes/No
]-
No
-
Yes —
-
Why are you initiating a dispute prior to the expected delivery date? [
Text
] -
What is the last expected receipt date for the merchandise? [
Date
]
-
-
-
[required] What was the expected receipt time for the merchandise? [
Date
] -
[required] Was the merchandise delivered to the incorrect location? [
Yes/No
]-
No
-
Yes — Please provide the address of the agreed upon location. [
Text
]
-
-
[required] Was the merchandise delivered late? [
Yes/No
]-
No — Did you attempt to return the merchandise? [
Yes/No
]-
No
-
Yes — When did you attempt to return it? [
Date
]
-
-
Yes — Please provide details of late delivery. [
Text
]
-
-
[required] Did you return the merchandise? [
Yes/No
]-
No
-
Yes —
-
When did you return the merchandise? [
Date
] -
Do you know when the merchant received the merchandise? [
Yes/No
]-
No
-
Yes —
- When did the merchant receive the merchandise? [
Date
]
- When did the merchant receive the merchandise? [
-
-
What return method did you use? [
BulletList
]-
Face to Face
-
FedEx — What was the tracking number? [
Text
] -
DHL — What was the tracking number? [
Text
] -
UPS — What was the tracking number? [
Text
] -
Postal Service — What was the tracking number? [
Text
] -
Other — Please explain: [
Text
]
-
-
-
-
[required] Did you cancel prior to the expected receipt date? [
Yes/No
]-
No
-
Yes — When did you cancel? [
Date
]
-
-
[required] Did you attempt to resolve with the merchant? [
Yes/No
]-
No — Are there local laws or regulations prohibiting you from resolving with the merchant? [
Yes/No
]-
No
-
Yes — Please explain. [
Text
]
-
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
― Service
-
[required] Did merchant cancel services? [
Yes/No
]-
No
-
Yes — Date the merchant cancelled services [
Date
]
-
-
[required] Is the merchant in bankruptcy or liquidation? [
Yes/No
]-
No
-
Yes
-
-
[required] Was non-fiat currency (e.g. cryptocurrency) or non-fungible token(s) not successfully delivered to the destination wallet address supplied by the Cardholder at the time of the Transaction? [
Yes/No
]-
No
-
Yes — Note: Please provide evidence that the non-fiat currency or non-fungible token(s) was not successfully delivered to the destination wallet address at the time of the Transaction. [
Text
]
-
-
[required] Are you still expecting a service delivery? [
Yes/No
]-
No
-
Yes —
-
Why are you initiating a dispute prior to the expected delivery date? [
Text
] -
What is the last expected receipt date for the service? [
Date
] -
What was the expected receipt time for the service? [
Date
] -
Did you cancel the service prior to the expected receipt date? [
Yes/No
]-
No
-
Yes —
-
When did you cancel? [
Date
] -
Why did you cancel? [
Text
]
-
-
-
-
-
[required] Did you attempt to resolve with the merchant? [
Yes/No
]-
No — Are there local laws or regulations prohibiting you from resolving with the merchant? [
Yes/No
]-
No
-
Yes — Please explain. [
Text
]
-
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
I cancelled or returned the merchandise or service and have not received the expected credit.
-
[required] Are you disputing the full amount of the transaction? [
Yes/No
]-
No —
-
What amount are you disputing? [
Text
] -
Why is the dispute different than the posted transaction amount? [
Text
]
-
-
Yes
-
-
[required] Were you provided a credit voucher, voided transaction receipt or refund acknowledgement? [
Yes/No
]-
No — When did you cancel the service or return the merchandise? [
Date
] -
Yes
-
-
[required] What was purchased? [
BulletList
]
― Merchandise
-
[required] Please provide details about the merchandise. [
Text
] -
[required] When did you receive or expect to receive the merchandise? [
Date
] -
[required] Did you receive the merchandise? [
Yes/No
]-
No
-
Yes
-
Did you return the merchandise? [
Yes/No
]-
No — Did you attempt to return the merchandise? [
Yes/No
]-
No
-
Yes —
-
When did you attempt to return it? [
Date
] -
Please provide a detailed description of how you attempted to return the merchandise. [
Text
] -
Where is the merchandise at this time? [
Text
] -
Please select one of the options below which best represents the return attempt. [
BulletList
]-
The merchant refused to provide return authorization.
-
The merchant refused to accept the returned merchandise.
-
The merchant informed not to return the merchandise.
-
The merchant no longer exists or is not responding.
-
The merchant did not provide clear instruction on how to return.
-
-
-
-
-
Yes —
-
When did you return the merchandise? [
Date
] -
Do you know when the merchant received the merchandise? [
Yes/No
]-
No
-
Yes —
- When did the merchant receive the merchandise? [
Date
]
- When did the merchant receive the merchandise? [
-
-
What return method did you use? [
BulletList
]-
Face to Face
-
FedEx — What was the tracking number? [
Text
] -
DHL — What was the tracking number? [
Text
] -
UPS — What was the tracking number? [
Text
] -
Postal Service — What was the tracking number? [
Text
] -
Other — Please explain: [
Text
]
-
-
-
-
-
[required] Did you cancel the order? [
Yes/No
]-
No
-
Yes —
-
When did you cancel?
-
Did you cancel prior to the shipment date? [
Yes/No
]-
No
-
Yes
-
-
Why did you cancel? [
Text
] -
Was a cancellation policy provided? [
Yes/No
]-
No
-
Yes
-
-
-
-
[required] Did you attempt to resolve with the merchant? [
Yes/No
]-
No — Are there local laws or regulations prohibiting you from resolving with the merchant? [
Yes/No
]-
No
-
Yes — Please explain. [
Text
]
-
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
― Service
-
[required] What type of service was it? [
BulletList
]-
Timeshare — What was the date of the timeshare, or when was the contract and/or related documents received? [
Date
] -
Guaranteed Reservation — When was the service provided or expected? [
Date
] -
Other — Please explain: [
Text
]
-
-
[required] Did you cancel the service? [
Yes/No
]-
No
-
Yes —
-
When did you cancel or attempt to cancel? [
Date
] -
Why did you cancel? [
Text
] -
Was a cancellation policy provided? [
Yes/No
]-
No
-
Yes
-
-
-
-
[required] Did you attempt to resolve with the merchant? [
Yes/No
]-
No — Are there local laws or regulations prohibiting you from resolving with the merchant? [
Yes/No
]-
No
-
Yes — Please explain. [
Text
]
-
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
Credit not processed. I cancelled or returned the merchandise or service and have not received the expected credit.
-
[required] Are you disputing the full amount of the transaction? [
Yes/No
]-
No —
- What amount are you disputing? [
Text
] - Why is the dispute different than the posted transaction amount? [
Text
]
- What amount are you disputing? [
-
Yes
-
-
[required] Were you provided a credit voucher, voided transaction receipt or refund acknowledgement? [
Yes/No
]-
No — Is the credit voucher, transaction receipt, or refund acknowledgement dated? [
Yes/No
]- No — When did you cancel the service or return the merchandise? [
Date
] - Yes — What is the date on the credit voucher, transaction receipt, or refund acknowledgement [
Date
]
- No — When did you cancel the service or return the merchandise? [
-
Yes
-
-
[required] What was purchased? [
BulletList
]
― Merchandise
-
[required] Please provide details about the merchandise. [
Text
] -
[required] When did you receive or expect to receive the merchandise? [
Date
] -
[required] Did you receive the merchandise? [
Yes/No
]-
No
-
Yes
-
Did you return the merchandise? [
Yes/No
]-
No — Did you attempt to return the merchandise? [
Yes/No
]-
No
-
Yes —
-
When did you attempt to return it? [
Date
] -
Please provide a detailed description of how you attempted to return the merchandise. [
Text
] -
Where is the merchandise at this time? [
Text
] -
Please select one of the options below which best represents the return attempt. [
BulletList
]-
The merchant refused to provide return authorization.
-
The merchant refused to accept the returned merchandise.
-
The merchant informed not to return the merchandise.
-
The merchant no longer exists or is not responding.
-
The merchant did not provide clear instruction on how to return.
-
-
-
-
Yes —
-
When did you return the merchandise? [
Date
] -
Do you know when the merchant received the merchandise? [
Yes/No
]-
No
-
Yes —
- When did the merchant receive the merchandise? [
Date
]
- When did the merchant receive the merchandise? [
-
-
What return method did you use? [
BulletList
]-
Face to Face
-
FedEx — What was the tracking number? [
Text
] -
DHL — What was the tracking number? [
Text
] -
UPS — What was the tracking number? [
Text
] -
Postal Service — What was the tracking number? [
Text
] -
Other — Please explain: [
Text
]
-
-
-
-
-
[required] Did you cancel the order? [
Yes/No
]-
No
-
Yes —
-
When did you cancel? [
Date
] -
Did you cancel prior to the shipment date? [
Yes/No
]-
No
-
Yes
-
-
Why did you cancel? [
Text
] -
Was a cancellation policy provided? [
Yes/No
]-
No
-
Yes
-
-
-
-
[required] Did you attempt to resolve with the merchant? [
Yes/No
]-
No — Are there local laws or regulations prohibiting you from resolving with the merchant? [
Yes/No
]- No
- Yes — Please explain. [
Text
]
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
― Service
-
[required] What type of service was it? [
BulletList
]-
Timeshare — What was the date of the timeshare, or when was the contract and/or related documents received? [
Date
] -
Guaranteed Reservation — When was the service provided or expected? [
Date
] -
Other — Please explain: [
Text
]
-
-
[required] Did you cancel the service? [
Yes/No
]-
No
-
Yes —
-
When did you cancel or attempt to cancel? [
Date
] -
Why did you cancel? [
Text
] -
Was a cancellation policy provided? [
Yes/No
]-
No
-
Yes
-
-
-
-
[required] Did you attempt to resolve with the merchant? [
Yes/No
]-
No — Are there local laws or regulations prohibiting you from resolving with the merchant? [
Yes/No
]- No
- Yes — Please explain. [
Text
]
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
I have an issue with a recurring transaction on my account.
-
[required] When did you cancel the recurring transaction? [
Date
] -
[required] Why did you cancel? [
Text
] -
[required] How did you contact the merchant to cancel? [
BulletList
]-
Call Center/SMS/Text Message — Which did you use to contact the merchant? [
BulletList
] -
Call Center
-
SMS/Text Message
-
Both
- Please provide the number you contacted. [
Text
]
- Please provide the number you contacted. [
-
Email — Please provide the email address you contacted. [
Text
] -
Mail — Please provide the mailing address you contacted. [
Text
] -
In-Person — Please provide the physical address you contacted. [
Text
] -
Application Name — Please provide the Application Name you used to cancel. [
Text
]
-
-
[required] Was another form of payment provided for this transaction? [
Yes/No
]-
No
-
Yes — Please describe the other form of payment. [
Text
]
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
I am dissatisfied with the merchandise or a service I received.
What is the issue with the merchandise or service?
The merchandise is counterfeit.
-
[required] Are you disputing the full amount of the transaction? [
Yes/No
]-
No —
- What amount are you disputing? [
Text
] - Why is the dispute different than the posted transaction amount? [
Text
]
- What amount are you disputing? [
-
Yes
-
-
[required] Please provide a description of what was ordered. [
Text
] -
[required] Please describe how the merchandise is counterfeit. [
Text
] -
[required] Please provide information about the entity that indicated the merchandise to be counterfeit. [
Text
] -
[required] When did you receive the merchandise or learn that it was counterfeit? [
Date
] -
[required] Please describe the disposition of the merchandise [
Text
] -
[required] Was the merchandise certified as counterfeit by any of the following? [
BulletList
]-
The owner of the intellectual property or its authorized representative.
-
Customs agency, law enforcement agency or other government agency.
-
A third-party expert.
-
None of the above.
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
The merchandise is damaged or defective.
-
[required] Are you disputing the full amount of the transaction? [
Yes/No
]-
No —
- What amount are you disputing? [
Text
] - Why is the dispute different than the posted transaction amount? [
Text
]
- What amount are you disputing? [
-
Yes
-
-
[required] Please provide a description of what was ordered. [
Text
] -
[required] When did you receive the merchandise/service? [
Date
] -
[required] Did you return the merchandise? [
Yes/No
]-
No — Did you attempt to return the merchandise? [
Yes/No
]-
No
-
Yes —
-
When did you attempt to return it? [
Date
] -
Please provide a detailed description of how you attempted to return the merchandise. [
Text
] -
Where is the merchandise at this time? [
Text
] -
Please select one of the options below which best represents the return attempt. [
BulletList
]-
The merchant refused to provide return authorization.
-
The merchant refused to accept the returned merchandise.
-
The merchant informed not to return the merchandise.
-
The merchant no longer exists or is not responding.
-
The merchant did not provide clear instruction on how to return.
-
-
-
-
Yes —
-
When did you return the merchandise? [
Date
] -
Do you know when the merchant received the merchandise? [
Yes/No
]-
No
-
Yes —
- When did the merchant receive the merchandise? [
Date
]
- When did the merchant receive the merchandise? [
-
-
What return method did you use? [
BulletList
]-
Face to Face
-
FedEx — What was the tracking number? [
Text
] -
DHL — What was the tracking number? [
Text
] -
UPS — What was the tracking number? [
Text
] -
Postal Service — What was the tracking number? [
Text
] -
Other — Please explain: [
Text
]
-
-
-
-
[required] Did you attempt to resolve with the merchant? [
Yes/No
]-
No — Are there local laws or regulations prohibiting you from resolving with the merchant? [
Yes/No
]- No
- Yes — Please explain. [
Text
]
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
The merchandise or service has a quality issue.
-
[required] Are you disputing the full amount of the transaction? [
Yes/No
]-
No —
-
What amount are you disputing? [
Text
] -
Why is the dispute different than the posted transaction amount? [
Text
]
-
-
Yes
-
-
[required] What was purchased? [
BulletList
]
― Merchandise
-
[required] Is dispute related to the quality of food received from eating places or restaurants? [
Yes/No
]-
No
-
Yes
-
-
[required] Please provide a description of the merchandise and the quality issue. [
Text
] -
[required] When did you receive the merchandise/service? [
Date
] -
[required] Did you return the merchandise? [
Yes/No
]-
No — Did you attempt to return the merchandise? [
Yes/No
]-
No
-
Yes —
-
When did you attempt to return it? [
Date
] -
Please provide a detailed description of how you attempted to return the merchandise. [
Text
] -
Where is the merchandise at this time? [
Text
] -
Please select one of the options below which best represents the return attempt. [
BulletList
]-
The merchant refused to provide return authorization.
-
The merchant refused to accept the returned merchandise.
-
The merchant informed not to return the merchandise.
-
The merchant no longer exists or is not responding.
-
The merchant did not provide clear instruction on how to return.
-
-
-
-
Yes —
-
When did you return the merchandise? [
Date
] -
Do you know when the merchant received the merchandise? [
Yes/No
]-
No
-
Yes —
- When did the merchant receive the merchandise? [
Date
]
- When did the merchant receive the merchandise? [
-
-
What return method did you use? [
BulletList
]-
Face to Face
-
FedEx — What was the tracking number? [
Text
] -
DHL — What was the tracking number? [
Text
] -
UPS — What was the tracking number? [
Text
] -
Postal Service — What was the tracking number? [
Text
] -
Other — Please explain: [
Text
]
-
-
-
-
[required] Did you attempt to resolve with the merchant? [
Yes/No
]-
No — Are there local laws or regulations prohibiting you from resolving with the merchant? [
Yes/No
]- No
- Yes — Please explain. [
Text
]
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
― Service
-
[required] Was non-fiat currency or purchase of non-fungible token(s) (NFT), the non-fiat currency or non-fungible token received by the cardholder did not match the description provided at the time of the transaction? [
Yes/No
]-
No
-
Yes
-
-
[required] Is dispute related to the quality of food received from eating places or restaurants? [
Yes/No
]-
No
-
Yes
-
-
[required] Please provide a description of the service and the quality issue. [
Text
] -
[required] When did you receive the service? [
Date
] -
[required] Did you have to pay for work to be redone? [
Yes/No
]-
No
-
Yes
-
-
[required] Did you cancel the service? [
Yes/No
]-
No
-
Yes —
-
When did you cancel? [
Date
] -
Why did you cancel? [
Text
] -
Did the merchant accept the cancellation? [
Yes/No
]-
No
-
Yes
-
-
-
-
[required] Did you attempt to resolve with the merchant? [
Yes/No
]-
No — Are there local laws or regulations prohibiting you from resolving with the merchant? [
Yes/No
]- No
- Yes — Please explain. [
Text
]
- Yes — Please explain. [
- No
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
The merchandise or service is not as described.
-
[required] Are you disputing the full amount of the transaction? [
Yes/No
]-
No —
- What amount are you disputing? [
Text
] - Why is the dispute different than the posted transaction amount? [
Text
]
- What amount are you disputing? [
-
Yes
-
-
[required] What was purchased? [
BulletList
]
― Merchandise
-
[required] Is dispute related to the quality of food received from eating places or restaurants? [
Yes/No
]-
No
-
Yes
-
-
[required] Please provide details of what was ordered and not as described. [
Text
] -
[required] When did you receive the merchandise/service? [
Date
] -
[required] Did you return the merchandise? [
Yes/No
]-
No — Did you attempt to return the merchandise? [
Yes/No
]-
No
-
Yes —
-
When did you attempt to return it? [
Date
] -
Please provide a detailed description of how you attempted to return the merchandise. [
Text
] -
Where is the merchandise at this time? [
Text
] -
Please select one of the options below which best represents the return attempt. [
BulletList
]-
The merchant refused to provide return authorization.
-
The merchant refused to accept the returned merchandise.
-
The merchant informed not to return the merchandise.
-
The merchant no longer exists or is not responding.
-
The merchant did not provide clear instruction on how to return.
-
-
-
-
Yes —
-
When did you return the merchandise? [
Date
] -
Do you know when the merchant received the merchandise? [
Yes/No
]-
No
-
Yes —
- When did the merchant receive the merchandise? [
Date
]
- When did the merchant receive the merchandise? [
-
-
What return method did you use?
-
Face to Face
-
FedEx — What was the tracking number? [
Text
] -
DHL — What was the tracking number? [
Text
] -
UPS — What was the tracking number? [
Text
] -
Postal Service — What was the tracking number? [
Text
] -
Other — Please explain: [
Text
]
-
-
-
-
[required] Did you attempt to resolve with the merchant? [
Yes/No
]-
No — Are there local laws or regulations prohibiting you from resolving with the merchant? [
Yes/No
]- No
- Yes — Please explain. [
Text
]
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
― Service
-
[required] Was non-fiat currency or purchase of non-fungible token(s) (NFT), the non-fiat currency or non-fungible token received by the cardholder did not match the description provided at the time of the transaction? [
Yes/No
]-
No
-
Yes
-
-
[required] Is dispute related to the quality of food received from eating places or restaurants? [
Yes/No
]-
No
-
Yes
-
-
[required] Please provide details of what was ordered and not as described. [
Text
] -
[required] When did you receive the service? [
Date
] -
[required] Did you cancel the service? [
Yes/No
]-
No
-
Yes —
-
When did you cancel? [
Date
] -
Why did you cancel? [
Text
] -
Did the merchant accept the cancellation? [
Yes/No
]-
No
-
Yes
-
-
-
-
[required] Did you attempt to resolve with the merchant? [
Yes/No
]-
No — Are there local laws or regulations prohibiting you from resolving with the merchant? [
Yes/No
]- No
- Yes — Please explain. [
Text
]
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
The terms of sale were misrepresented.
-
[required] Are you disputing the full amount of the transaction? [
Yes/No
]-
No —
- What amount are you disputing? [
Text
]- Why is the dispute different than the posted transaction amount? [
Text
]
- Why is the dispute different than the posted transaction amount? [
- What amount are you disputing? [
-
Yes
-
-
[required] What was purchased? [
BulletList
]
― Merchandise
-
[required] Please provide details of what was ordered. [
Text
] -
[required] When did you receive the merchandise/service? [
Date
] -
[required] How was the merchandise/service misrepresented? [
Text
] -
[required] Did you return the merchandise? [
Yes/No
]-
No — Did you attempt to return the merchandise? [
Yes/No
]-
No
-
Yes —
-
When did you attempt to return it? [
Date
] -
Please provide a detailed description of how you attempted to return the merchandise. [
Text
] -
Where is the merchandise at this time? [
Text
] -
Please select one of the options below which best represents the return attempt. [
BulletList
]-
The merchant refused to provide return authorization.
-
The merchant refused to accept the returned merchandise.
-
The merchant informed not to return the merchandise.
-
The merchant no longer exists or is not responding.
-
The merchant did not provide clear instruction on how to return.
-
-
-
-
Yes —
-
When did you return the merchandise? [
Date
] -
Do you know when the merchant received the merchandise? [
Yes/No
]-
No
-
Yes —
- When did the merchant receive the merchandise? [
Date
]
- When did the merchant receive the merchandise? [
-
-
What return method did you use? [
BulletList
]-
Face to Face
-
FedEx — What was the tracking number? [
Text
] -
DHL — What was the tracking number? [
Text
] -
UPS — What was the tracking number? [
Text
] -
Postal Service — What was the tracking number? [
Text
] -
Other — Please explain: [
Text
]
-
-
-
-
[required] Did you attempt to resolve with the merchant? [
Yes/No
]-
No — Are there local laws or regulations prohibiting you from resolving with the merchant? [
Yes/No
]- No
- Yes — Please explain. [
Text
]
- Yes — Please explain. [
- No
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
― Service
-
[required] Please provide a description of what was purchased. [
Text
] -
[required] When did you receive the service? [
Date
] -
[required] How was the merchandise/service misrepresented? [
Text
] -
[required] Did you cancel the service? [
Yes/No
]-
No
-
Yes —
-
When did you cancel? [
Date
] -
Why did you cancel? [
Text
] -
Did the merchant accept the cancellation? [
Yes/No
]-
No
-
Yes
-
-
-
-
[required] Did you attempt to resolve with the merchant? [
Yes/No
]-
No — Are there local laws or regulations prohibiting you from resolving with the merchant? [
Yes/No
]- No
- Yes — Please explain. [
Text
]
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
I was charged or credited incorrectly
How were you charged or credited incorrectly?
I was charged the wrong amount
-
[required] Are you disputing the full amount of the transaction? [
Yes/No
]-
No
-
Yes — To dispute a transaction for an incorrect amount, the amount disputed must be less than the full transaction amount. Please go back and choose a new claim reason.
-
-
[required] What is the correct amount that should have been charged? [
Text
] -
[required] What is the amount shown on your receipt or confirmation? [
Text
] -
[required] Is the dispute due to the difference between the quoted price and the actual charges made by the merchant? [
Yes/No
]-
No
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
I was charged a long time after the transaction occurred
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
Invalid Data
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
Incorrect Currency
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
Incorrect Account Number
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-
I was charged more than once.
The duplicate transaction must be selected for the claim reason Charged More Than Once.
-
[required] Is the valid transaction on this same account? [
Yes/No
]-
No — Is the other transaction on a Galileo card? [
Yes/No
]-
No — What was the other form of payment? [
BulletList
]-
Another Visa
-
Another Card
-
Check
-
Cash
-
Other — Please explain. [
Text
]
-
-
Yes —
-
Select the account the charge(s) appear on (
/claim/intake/retrieveOtherAccounts
): [Selector] -
Please select a valid transaction. (
/claim/intake/retrieveSimilarTransactions
). [Selector]
-
-
-
Yes — Please select a valid transaction. (
/claim/intake/retrieveSimilarTransactions
). [Selector]
-
-
[required] Did you attempt to resolve with the merchant? [
Yes/No
]-
No — Are there local laws or regulations prohibiting you from resolving with the merchant? [
Yes/No
]- No
- Yes — Please explain. [
Text
]
-
Yes
-
-
[required] Do you have any additional information that should be provided to the merchant regarding your dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. This will be provided to the merchant. [
Text
]
-
-
[required] Do you have any additional information to provide about this dispute? [
Yes/No
]-
No
-
Yes — Please provide any additional information. [
Text
]
-