Visa Questionnaire

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.

Are you disputing the full amount of the transaction?
- No —
  - What amount are you disputing?
  - Why is the dispute different than the posted transaction amount?
- Yes
- 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?
  - No
  - Yes
- What was not received?

― Merchandise

Did the merchant cancel the merchandise?
No
Yes —
- Date merchant cancelled merchandise
- Is the merchant in bankruptcy or liquidation?
  - No
  - Yes
Are you still expecting a delivery for the merchandise?
- No
- Yes —
  - Why are you initiating a dispute prior to the expected delivery date?
  - What is the last expected receipt date for the merchandise?
What was the expected receipt time for the merchandise?
Was the merchandise delivered to the incorrect location?
- No
- Yes — Please provide the address of the agreed upon location.
Was the merchandise delivered late?
- No — Did you attempt to return the merchandise?
  - No
  - Yes — When did you attempt to return it?
- Yes — Please provide details of late delivery.
Did you return the merchandise?
- No
- Yes —
  - When did you return the merchandise?
  - Do you know when the merchant received the merchandise?
    - No
    - Yes —
      - When did the merchant receive the merchandise?
  - What return method did you use?
    - Face to Face
    - FedEx — What was the tracking number?
    - DHL — What was the tracking number?
    - UPS — What was the tracking number?
    - Postal Service — What was the tracking number?
    - Other — Please explain:
    - Did you cancel prior to the expected receipt date?
      - No
      - Yes — When did you cancel?
Did you attempt to resolve with the merchant?
- No — Are there local laws or regulations prohibiting you from resolving with the merchant?
  - No
  - Yes — Please explain.
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Values	Requirement level	Notes
Did the merchant cancel the merchandise?	Yes/No		Mandatory
Date merchant cancelled merchandise	Date		Conditional	When “Yes” to “Did the merchant cancel the merchandise?”
Is the merchant in bankruptcy or liquidation?	Yes/No		Mandatory
Are you still expecting a delivery for the merchandise?	Yes/No		Mandatory
What is the last expected receipt date for the merchandise?	Date		Mandatory
Why are you initiating a dispute prior to the expected delivery date?	Freeform Text		Conditional	When “Yes” to “Are you still expecting a delivery for the merchandise?”
What was the expected receipt time for the merchandise?	Freeform Text		Mandatory
Was the merchandise delivered to the incorrect location?	Yes/No		Mandatory
Please provide the address of the agreed upon location.	Freeform Text		Conditional	When “Yes” to “Was the merchandise delivered to the incorrect location?”
Was the merchandise delivered late?	Yes/No		Mandatory
Please provide details of late delivery.	Freeform Text		Conditional	When “Yes” to “Was the merchandise delivered late?”
Did you return the merchandise?	Yes/No		Conditional	Follows “Please provide details of late delivery.”
Did you attempt to return the merchandise?	Yes/No		Conditional	When “No” to “Was the merchandise delivered late?”
When did you attempt to return it?	Date		Conditional	When “Yes” to “Did you attempt to return the merchandise?”
When did you return the merchandise?	Date		Conditional	When “Yes” to “Was the merchandise delivered late?”
Do you know when the merchant received the merchandise?	Yes/No		Conditional	Follows “When did you return the merchandise?”
When did the merchant receive the merchandise?	Date		Conditional	When “Yes” to “Do you know when the merchant received the merchandise?”
What return method did you use?	Single Select	Face to Face FedEx DHL UPS Postal Service Other	Conditional
Please explain:	Freeform Text		Conditional	When “Other” to “What return method did you use?”
What was the tracking number?	Freeform Text		Conditional	When either ”FedEx,” “DHL,” “UPS,” “Postal Service,” is selected to “What return method did you use?”
Did you cancel prior to the expected receipt date?	Yes/No		Mandatory
When did you cancel?	Date		Conditional	When “Yes” to “Did you cancel prior to the expected receipt date?”
Did you attempt to resolve with the merchant?	Yes/No		Mandatory
Are there local laws or regulations prohibiting you from resolving with the merchant?	Yes/No		Conditional	When “No” to “Did you attempt to resolve with the merchant?”
Please explain.	Freeform Text		Conditional	When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No		Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”
Do you have any additional information to provide about this dispute?	Yes/No		Mandatory
Please provide any additional information.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information to provide about this dispute?”

― Service

Did merchant cancel services?
- No
- Yes — Date the merchant cancelled services
Is the merchant in bankruptcy or liquidation?
- No
- Yes
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?
- 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.
Are you still expecting a service delivery?
- No
- Yes —
  - Why are you initiating a dispute prior to the expected delivery date?
  - What is the last expected receipt date for the service?
  - What was the expected receipt time for the service?
  - Did you cancel the service prior to the expected receipt date?
    - No
    - Yes —
      - When did you cancel?
      - Why did you cancel?
Did you attempt to resolve with the merchant?
- No — Are there local laws or regulations prohibiting you from resolving with the merchant?
  - No
  - Yes — Please explain.
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Requirement level	Notes
Did merchant cancel services?	Yes/No	Mandatory
Date the merchant cancelled services	Date	Conditional	When “Yes” to “Did merchant cancel services?”
Is the merchant in bankruptcy or liquidation?	Yes/No	Mandatory
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	Mandatory
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.		Conditional	When “Yes” to “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?”
Are you still expecting a service delivery?	Yes/No	Mandatory
What is the last expected receipt date for the service?	Date	Mandatory
Why are you initiating a dispute prior to the expected delivery date?	Freeform Text	Conditional	When “Yes” to “Are you still expecting a service delivery?”
What was the expected receipt time for the service?	Freeform Text	Mandatory
Did you cancel the service prior to the expected receipt date?	Yes/No	Mandatory
When did you cancel?	Date	Conditional	When “Yes” to “Did you cancel prior to the expected receipt date?”
Why did you cancel?	Freeform Text	Conditional	Follows “When did you cancel?”
Did you attempt to resolve with the merchant?	Yes/No	Mandatory
Are there local laws or regulations prohibiting you from resolving with the merchant?	Yes/No	Conditional	When “No” to “Did you attempt to resolve with the merchant?”
Please explain.	Freeform Text	Conditional	When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No	Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text	Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”
Do you have any additional information to provide about this dispute?	Yes/No	Mandatory

I cancelled or returned the merchandise or service and have not received the expected credit.

Are you disputing the full amount of the transaction?
- No —
  - What amount are you disputing?
  - Why is the dispute different than the posted transaction amount?
- Yes
Were you provided a credit voucher, voided transaction receipt or refund acknowledgement?
- No — When did you cancel the service or return the merchandise?
- Yes
What was purchased?

― Merchandise

Please provide details about the merchandise.
When did you receive or expect to receive the merchandise?
Did you receive the merchandise?
- No
- Yes
  - Did you return the merchandise?
    - No — Did you attempt to return the merchandise?
      - No
      - Yes —
        
        When did you attempt to return it?
        
        Please provide a detailed description of how you attempted to return the merchandise.
        
        Where is the merchandise at this time?
        
        Please select one of the options below which best represents the return attempt.
        
        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?
    - Do you know when the merchant received the merchandise?
      - No
      - Yes —
        
        When did the merchant receive the merchandise?
      - What return method did you use?
        
        Face to Face
        
        FedEx — What was the tracking number?
        
        DHL — What was the tracking number?
        
        UPS — What was the tracking number?
        
        Postal Service — What was the tracking number?
        
        Other — Please explain:
Did you cancel the order?
- No
- Yes —
  - When did you cancel?
  - Did you cancel prior to the shipment date?
    - No
    - Yes
  - Why did you cancel?
  - Was a cancellation policy provided?
    - No
    - Yes
Did you attempt to resolve with the merchant?
- No — Are there local laws or regulations prohibiting you from resolving with the merchant?
  - No
  - Yes — Please explain.
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Values	Requirement level	Notes
Please provide details about the merchandise.	Freeform Text		Mandatory
When did you receive or expect to receive the merchandise?	Date		Mandatory
Did you receive the merchandise?	Yes/No		Mandatory
Did you return the merchandise?	Yes/No		Mandatory
Did you attempt to return the merchandise?	Yes/No		Conditional	When “No” to “Did you return the merchandise?”
When did you attempt to return it?	Date		Conditional	When “Yes” to “Did you attempt to return the merchandise?”
Please provide a detailed description of how you attempted to return the merchandise.	Freeform Text		Conditional	Follows “When did you attempt to return it?”
Where is the merchandise at this time?	Freeform Text		Conditional	Follows “Please provide a detailed description of how you attempted to return the merchandise.”
Please select one of the options below which best represents the return attempt.	Single Select	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.	Conditional	Follows “Where is the merchandise at this time?”
When did you return the merchandise?	Date		Conditional	When “Yes” to “Did you return the merchandise?”
Do you know when the merchant received the merchandise?	Yes/No		Conditional	Follows “When did you return the merchandise?”
When did the merchant receive the merchandise?	Date		Conditional	When “Yes” to “Do you know when the merchant received the merchandise?”
What return method did you use?	Single Select	Face to Face FedEx DHL UPS Postal Service Other	Conditional
Please Explain:	Freeform Text		Conditional	When “Other” to “What return method did you use?”
What was the tracking number?	Freeform Text		Conditional	When either ”FedEx,” “DHL,” “UPS,” “Postal Service,” is selected to “What return method did you use?”
Did you cancel the order?	Yes/No		Mandatory
When did you cancel?	Date		Conditional	When “Yes” to “Did you cancel the order?”
Did you cancel prior to the shipment date?	Yes/No		Conditional	Follows “When did you cancel?”
Why did you cancel?	Freeform Text		Conditional	Follows “Did you cancel prior to the shipment date?”
Was a cancellation policy provided?	Yes/No		Mandatory
Did you attempt to resolve with the merchant?	Yes/No		Mandatory
Are there local laws or regulations prohibiting you from resolving with the merchant?	Yes/No		Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
Please explain.	Freeform Text		Conditional	When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No		Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”

― Service

What type of service was it?
- Timeshare — What was the date of the timeshare, or when was the contract and/or related documents received?
- Guaranteed Reservation — When was the service provided or expected?
- Other — Please explain:
Did you cancel the service?
- No
- Yes —
  - When did you cancel or attempt to cancel?
  - Why did you cancel?
  - Was a cancellation policy provided?
    - No
    - Yes
Did you attempt to resolve with the merchant?
- No — Are there local laws or regulations prohibiting you from resolving with the merchant?
  - No
  - Yes — Please explain.
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Values	Requirement level	Notes
What type of service was it?	Single Select	Timeshare Guaranteed Reservation Other	Mandatory
What was the date of the timeshare, or when was the contract and/or related documents received?	Date		Conditional	If “Timeshare” is selected under “What type of service was it?”
When was the service provided or expected?	Date		Conditional	If “Guaranteed Reservation” is selected under “What type of service was it?”
Please explain:	Freeform Text		Conditional	If “Other” is selected under “What type of service was it?”
When was the service provided or expected?	Date		Conditional	Follows “Please Explain:”
Did you cancel the service?	Yes/No		Mandatory
When did you cancel or attempt to cancel?	Date		Conditional	When “Yes” to “Did you cancel the service?”
Why did you cancel?	Freeform Text		Conditional	Follows “When did you cancel or attempt to cancel?”
Was a cancellation policy provided?	Yes/No		Mandatory
What was the policy?	Freeform Text		Conditional	When “Yes” to “Was a cancellation policy provided?”
Did you attempt to resolve with the merchant?	Yes/No		Mandatory
Are there local laws or regulations prohibiting you from resolving with the merchant?	Yes/No		Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
Please explain.	Freeform Text		Conditional	When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No		Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”

Credit not processed. I cancelled or returned the merchandise or service and have not received the expected credit.

Are you disputing the full amount of the transaction?
- No —
  - What amount are you disputing?
  - Why is the dispute different than the posted transaction amount?
- Yes
Were you provided a credit voucher, voided transaction receipt or refund acknowledgement?
- No — Is the credit voucher, transaction receipt, or refund acknowledgement dated?
  - No — When did you cancel the service or return the merchandise?
  - Yes — What is the date on the credit voucher, transaction receipt, or refund acknowledgement
- Yes
What was purchased?

― Merchandise

Please provide details about the merchandise.
When did you receive or expect to receive the merchandise?
Did you receive the merchandise?
- No
- Yes
  - Did you return the merchandise?
    - No — Did you attempt to return the merchandise?
      - No
      - Yes —
        
        When did you attempt to return it?
        
        Please provide a detailed description of how you attempted to return the merchandise.
        
        Where is the merchandise at this time?
        
        Please select one of the options below which best represents the return attempt.
        
        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?
      - Do you know when the merchant received the merchandise?
        
        No
        
        Yes —
        
        When did the merchant receive the merchandise?
        
        What return method did you use?
        
        Face to Face
        
        FedEx — What was the tracking number?
        
        DHL — What was the tracking number?
        
        UPS — What was the tracking number?
        
        Postal Service — What was the tracking number?
        
        Other — Please explain:
Did you cancel the order?
- No
- Yes —
  - When did you cancel?
  - Did you cancel prior to the shipment date?
  - Why did you cancel?
  - Was a cancellation policy provided?
    - No
    - Yes
Did you attempt to resolve with the merchant?
- No — Are there local laws or regulations prohibiting you from resolving with the merchant?
  - No
  - Yes — Please explain.
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Values	Requirement level	Notes
Please provide details about the merchandise.	Freeform Text		Mandatory
When did you receive or expect to receive the merchandise?	Date		Mandatory
Did you receive the merchandise?	Yes/No		Mandatory
Did you return the merchandise?	Yes/No		Mandatory
Did you attempt to return the merchandise?	Yes/No		Conditional	When “No” to “Did you return the merchandise?”
When did you attempt to return it?	Date		Conditional	When “Yes” to “Did you attempt to return the merchandise?”
Please provide a detailed description of how you attempted to return the merchandise.	Freeform Text		Conditional	Follows “When did you attempt to return it?”
Where is the merchandise at this time?	Freeform Text		Conditional	Follows “Please provide a detailed description of how you attempted to return the merchandise.”
Please select one of the options below which best represents the return attempt.	Single Select	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.	Conditional	Follows “Where is the merchandise at this time?”
When did you return the merchandise?	Date		Conditional	When “Yes” to “Did you return the merchandise?”
Do you know when the merchant received the merchandise?	Yes/No		Conditional	Follows “When did you return the merchandise?”
When did the merchant receive the merchandise?	Date		Conditional	When “Yes” to “Do you know when the merchant received the merchandise?”
What return method did you use?	Single Select	Face to Face FedEx DHL UPS Postal Service Other	Conditional
Please Explain:	Freeform Text		Conditional	When “Other” to “What return method did you use?”
What was the tracking number?	Freeform Text		Conditional	When either ”FedEx,” “DHL,” “UPS,” “Postal Service,” is selected to “What return method did you use?”
Did you cancel the order?	Yes/No		Mandatory
When did you cancel?	Date		Conditional	When “Yes” to “Did you cancel the order?”
Did you cancel prior to the shipment date?	Yes/No		Conditional	Follows “When did you cancel?”
Why did you cancel?	Freeform Text		Conditional	Follows “Did you cancel prior to the shipment date?”
Was a cancellation policy provided?	Yes/No		Mandatory
Did you attempt to resolve with the merchant?	Yes/No		Mandatory
Are there local laws or regulations prohibiting you from resolving with the merchant?	Yes/No		Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
Please explain.	Freeform Text		Conditional	When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No		Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”

― Service

What type of service was it?
- Timeshare — What was the date of the timeshare, or when was the contract and/or related documents received?
- Guaranteed Reservation — When was the service provided or expected?
- Other — Please explain:
Did you cancel the service?
- No
- Yes —
  - When did you cancel or attempt to cancel?
  - Why did you cancel?
  - Was a cancellation policy provided?
    - No
    - Yes
Did you attempt to resolve with the merchant?
- No — Are there local laws or regulations prohibiting you from resolving with the merchant?
  - No
  - Yes — Please explain.
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Values	Requirement level	Notes
What type of service was it?	Single Select	Timeshare Guaranteed Reservation Other	Mandatory
What was the date of the timeshare, or when was the contract and/or related documents received?	Date		Conditional	If “Timeshare” is selected under “What type of service was it?”
When was the service provided or expected?	Date		Conditional	If “Guaranteed Reservation” is selected under “What type of service was it?”
Please Explain:	Freeform Text		Conditional	If “Other” is selected under “What type of service was it?”
When was the service provided or expected?	Date		Conditional	Follows “Please Explain:”
Did you cancel the service?	Yes/No		Mandatory
When did you cancel or attempt to cancel?	Date		Conditional	When “Yes” to “Did you cancel the service?”
Why did you cancel?	Freeform Text		Conditional	Follows “When did you cancel or attempt to cancel?”
Was a cancellation policy provided?	Yes/No		Mandatory
What was the policy?	Freeform Text		Conditional	When “Yes” to “Was a cancellation policy provided?”
Did you attempt to resolve with the merchant?	Yes/No		Mandatory
Are there local laws or regulations prohibiting you from resolving with the merchant?	Yes/No		Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
Please explain.	Freeform Text		Conditional	When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No		Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”

I have an issue with a recurring transaction on my account.

When did you cancel the recurring transaction?
Why did you cancel?
How did you contact the merchant to cancel?
- Call Center/SMS/Text Message — Which did you use to contact the merchant?
  - Call Center
  - SMS/Text Message
  - Both
    - Please provide the number you contacted.
- Email — Please provide the email address you contacted.
- Mail — Please provide the mailing address you contacted.
- In-Person — Please provide the physical address you contacted.
- Application Name — Please provide the Application Name you used to cancel.
Was another form of payment provided for this transaction?
- No
- Yes — Please describe the other form of payment.
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Values	Requirement level	Notes
When did you cancel the recurring transaction?	Date		Mandatory
Why did you cancel?	Freeform Text		Mandatory
How did you contact the merchant to cancel?	Single Select	Call Center/SMS/Text Message Email Mail In-Person Application Name	Mandatory
Which did you use to contact the merchant?	Single Select	Call Center SMS/Text Message Both	Conditional	When “Call Center/SMS/Text Message” is selected under “How did you contact the merchant to cancel?”
Please provide the number you contacted.	Freeform Text		Conditional	Follows “Which did you use to contact the merchant?”
Please provide the email address you contacted.	Freeform Text		Conditional	When “Email” is selected under “How did you contact the merchant to cancel?”
Please provide the mailing address you contacted.	Freeform Text		Conditional	When “Mail” is selected under “How did you contact the merchant to cancel?”
Please provide the physical address you contacted.	Freeform Text		Conditional	When “In-Person” is selected under “How did you contact the merchant to cancel?”
Please provide the Application Name you used to cancel.	Freeform Text		Conditional	When “Application Name” is selected under “How did you contact the merchant to cancel?”
Was another form of payment provided for this transaction?	Yes/No		Mandatory
Please describe the other form of payment.	Freeform Text		Conditional	When “Yes” to “Was another form of payment provided for this transaction?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No		Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”
Do you have any additional information to provide about this dispute?	Yes/No		Mandatory
Please provide any additional information.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information to provide about this dispute?”

I am dissatisfied with the merchandise or a service I received.

What is the issue with the merchandise or service?

The merchandise is counterfeit.

Are you disputing the full amount of the transaction?
- No —
  - What amount are you disputing?
  - Why is the dispute different than the posted transaction amount?
- Yes
Please provide a description of what was ordered.
Please describe how the merchandise is counterfeit.
Please provide information about the entity that indicated the merchandise to be counterfeit.
When did you receive the merchandise or learn that it was counterfeit?
Please describe the disposition of the merchandise
Was the merchandise certified as counterfeit by any of the following?
- 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.
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Values	Requirement level	Notes
Are you disputing the full amount of the transaction?	Yes/No		Mandatory
What amount are you disputing?	Freeform Text		Conditional	When “No” to “Are you disputing the full amount of the transaction?”
Why is the dispute different than the posted transaction amount?	Freeform Text		Conditional	Follows “What amount are you disputing?”
Please provide a description of what was ordered.	Freeform Text		Mandatory
Please describe how the merchandise is counterfeit.	Freeform Text		Mandatory
Please provide information about the entity that indicated the merchandise to be counterfeit.	Freeform Text		Mandatory
When did you receive the merchandise or learn that it was counterfeit?	Date		Mandatory
Please describe the disposition of the merchandise	Freeform Text		Mandatory
Was the merchandise certified as counterfeit by any of the following?	Single Select	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.
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No		Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”
Do you have any additional information to provide about this dispute?	Yes/No		Mandatory
Please provide any additional information.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information to provide about this dispute?”

The merchandise is damaged or defective.

Are you disputing the full amount of the transaction?
- No —
  - What amount are you disputing?
  - Why is the dispute different than the posted transaction amount?
- Yes
Please provide a description of what was ordered.
When did you receive the merchandise/service?
Did you return the merchandise?
- No — Did you attempt to return the merchandise?
  - No
  - Yes —
    - When did you attempt to return it?
    - Please provide a detailed description of how you attempted to return the merchandise.
    - Where is the merchandise at this time?
    - Please select one of the options below which best represents the return attempt.
      - 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?
  - Do you know when the merchant received the merchandise?
    - No
    - Yes —
      - When did the merchant receive the merchandise?
      - What return method did you use?
        
        Face to Face
        
        FedEx — What was the tracking number?
        
        DHL — What was the tracking number?
        
        UPS — What was the tracking number?
        
        Postal Service — What was the tracking number?
        
        Other — Please explain:
Did you attempt to resolve with the merchant?
- No — Are there local laws or regulations prohibiting you from resolving with the merchant?
  - No
  - Yes — Please explain.
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Values	Requirement level	Notes
Are you disputing the full amount of the transaction?	Yes/No		Mandatory
What amount are you disputing?	Freeform Text		Conditional	When “No” to “Are you disputing the full amount of the transaction?”
Why is the dispute different than the posted transaction amount?	Freeform Text		Conditional	Follows “What amount are you disputing?”
Please provide a description of what was ordered.	Freeform Text		Mandatory
When did you receive the merchandise/service?	Date		Mandatory
Did you return the merchandise?	Yes/No		Mandatory
Did you attempt to return the merchandise?	Yes/No		Conditional	When “No” to “Did you return the merchandise?”
When did you attempt to return it?	Date		Conditional	When “Yes” to “Did you attempt to return the merchandise?”
Please provide a detailed description of how you attempted to return the merchandise.	Freeform Text		Conditional	Follows “When did you attempt to return it?”
Where is the merchandise at this time?	Freeform Text		Conditional	Follows “Please provide a detailed description of how you attempted to return the merchandise.”
Please select one of the options below which best represents the return attempt.	Single Select	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.	Conditional	Follows “Where is the merchandise at this time?”
When did you return the merchandise?	Date		Conditional	When “Yes” to “Did you return the merchandise?”
Do you know when the merchant received the merchandise?	Yes/No		Conditional	Follows “When did you return the merchandise?”
When did the merchant receive the merchandise?	Date		Conditional	When “Yes” to “Do you know when the merchant received the merchandise?”
What return method did you use?	Single Select	Face to Face FedEx DHL UPS Postal Service Other	Conditional
Please Explain:	Freeform Text		Conditional	When “Other” to “What return method did you use?”
What was the tracking number?	Freeform Text		Conditional	When either ”FedEx,” “DHL,” “UPS,” “Postal Service,” is selected to “What return method did you use?”
Did you attempt to resolve with the merchant?	Yes/No		Mandatory
Are there local laws or regulations prohibiting you from resolving with the merchant?	Yes/No		Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
Please explain.	Freeform Text		Conditional	When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No		Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”
Do you have any additional information to provide about this dispute?	Yes/No		Mandatory
Please provide any additional information.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information to provide about this dispute?”

The merchandise or service has a quality issue.

Are you disputing the full amount of the transaction?
No —
- What amount are you disputing?
- Why is the dispute different than the posted transaction amount?
Yes
What was purchased?

― Merchandise

Is dispute related to the quality of food received from eating places or restaurants?
- No
- Yes
Please provide a description of the merchandise and the quality issue.
When did you receive the merchandise/service?
Did you return the merchandise?
- No — Did you attempt to return the merchandise?
  - No
  - Yes —
    - When did you attempt to return it?
    - Please provide a detailed description of how you attempted to return the merchandise.
    - Where is the merchandise at this time?
    - Please select one of the options below which best represents the return attempt.
      - 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?
  - Do you know when the merchant received the merchandise?
    - No
    - Yes —
      - When did the merchant receive the merchandise?
      - What return method did you use?
        
        Face to Face
        
        FedEx — What was the tracking number?
        
        DHL — What was the tracking number?
        
        UPS — What was the tracking number?
        
        Postal Service — What was the tracking number?
        
        Other — Please explain:
Did you attempt to resolve with the merchant?
- No — Are there local laws or regulations prohibiting you from resolving with the merchant?
  - No
  - Yes — Please explain.
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Values	Requirement level	Notes
Is dispute related to the quality of food received from eating places or restaurants?	Yes/No		Mandatory
Please provide a description of the merchandise and the quality issue.	Freeform Text		Mandatory
When did you receive the merchandise/service?	Date		Mandatory
Did you return the merchandise?	Yes/No		Mandatory
Did you attempt to return the merchandise?	Yes/No		Conditional	When “No” to “Did you return the merchandise?”
When did you attempt to return it?	Date		Conditional	When “Yes” to “Did you attempt to return the merchandise?”
Please provide a detailed description of how you attempted to return the merchandise.	Freeform Text		Conditional	Follows “When did you attempt to return it?”
Where is the merchandise at this time?	Freeform Text		Conditional	Follows “Please provide a detailed description of how you attempted to return the merchandise.”
Please select one of the options below which best represents the return attempt.	Single Select	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.	Conditional	Follows “Where is the merchandise at this time?”
When did you return the merchandise?	Date		Conditional	When “Yes” to “Did you return the merchandise?”
Do you know when the merchant received the merchandise?	Yes/No		Conditional	Follows “When did you return the merchandise?”
When did the merchant receive the merchandise?	Date		Conditional	When “Yes” to “Do you know when the merchant received the merchandise?”
What return method did you use?	Single Select	Face to Face FedEx DHL UPS Postal Service Other	Conditional
Please Explain:	Freeform Text		Conditional	When “Other” to “What return method did you use?”
What was the tracking number?	Freeform Text		Conditional	When either ”FedEx,” “DHL,” “UPS,” “Postal Service,” is selected to “What return method did you use?”
Did you attempt to resolve with the merchant?	Yes/No		Mandatory
Are there local laws or regulations prohibiting you from resolving with the merchant?	Yes/No		Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
Please explain.	Freeform Text		Conditional	When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No		Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”

― Service

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?
- No
- Yes
Is dispute related to the quality of food received from eating places or restaurants?
- No
- Yes
Please provide a description of the service and the quality issue.
When did you receive the service?
Did you have to pay for work to be redone?
- No
- Yes
Did you cancel the service?
- No
- Yes —
  - When did you cancel?
  - Why did you cancel?
  - Did the merchant accept the cancellation?
    - No
    - Yes
Did you attempt to resolve with the merchant?
- No — Are there local laws or regulations prohibiting you from resolving with the merchant?
  - No
  - Yes — Please explain.
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Requirement level	Notes
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	Mandatory
Is dispute related to the quality of food received from eating places or restaurants?	Yes/No	Mandatory
Please provide a description of the service and the quality issue.	Freeform Text	Mandatory
When did you receive the service?	Date	Mandatory
Did you have to pay for work to be redone?	Yes/No	Mandatory
Did you cancel the service?	Yes/No	Mandatory
When did you cancel?	Date	Conditional	When “Yes” to “Did you cancel the service?”
Why did you cancel?	Freeform Text	Conditional	Follows “When did you cancel?”
Did the merchant accept the cancellation?	Yes/No	Conditional	Follows “Why did you cancel?”
Did you attempt to resolve with the merchant?	Yes/No	Mandatory
Are there local laws or regulations prohibiting you from resolving with the merchant?	Yes/No	Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
Please explain.	Freeform Text	Conditional	When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No	Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text	Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”

The merchandise or service is not as described.

Are you disputing the full amount of the transaction?
- No —
  - What amount are you disputing?
  - Why is the dispute different than the posted transaction amount?
- Yes
What was purchased?

― Merchandise

Is dispute related to the quality of food received from eating places or restaurants?
- No
- Yes
Please provide details of what was ordered and not as described.
When did you receive the merchandise/service?
Did you return the merchandise?
- No — Did you attempt to return the merchandise?
  - No
  - Yes —
    - When did you attempt to return it?
    - Please provide a detailed description of how you attempted to return the merchandise.
    - Where is the merchandise at this time?
    - Please select one of the options below which best represents the return attempt.
      - 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?
  - Do you know when the merchant received the merchandise?
    - No
    - Yes —
      - When did the merchant receive the merchandise?
      - What return method did you use?
        
        Face to Face
        
        FedEx — What was the tracking number?
        
        DHL — What was the tracking number?
        
        UPS — What was the tracking number?
        
        Postal Service — What was the tracking number?
        
        Other — Please explain:
Did you attempt to resolve with the merchant?
- No — Are there local laws or regulations prohibiting you from resolving with the merchant?
  - No
  - Yes — Please explain.
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Values	Requirement level	Notes
Is dispute related to the quality of food received from eating places or restaurants?	Yes/No		Mandatory
Please provide details of what was ordered and not as described.	Freeform Text		Mandatory
When did you receive the merchandise/service?	Date		Mandatory
Did you return the merchandise?	Yes/No		Mandatory
Did you attempt to return the merchandise?	Yes/No		Conditional	When “No” to “Did you return the merchandise?”
When did you attempt to return it?	Date		Conditional	When “Yes” to “Did you attempt to return the merchandise?”
Please provide a detailed description of how you attempted to return the merchandise.	Freeform Text		Conditional	Follows “When did you attempt to return it?”
Where is the merchandise at this time?	Freeform Text		Conditional	Follows “Please provide a detailed description of how you attempted to return the merchandise.”
Please select one of the options below which best represents the return attempt.	Single Select	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.	Conditional	Follows “Where is the merchandise at this time?”
When did you return the merchandise?	Date		Conditional	When “Yes” to “Did you return the merchandise?”
Do you know when the merchant received the merchandise?	Yes/No		Conditional	Follows “When did you return the merchandise?”
When did the merchant receive the merchandise?	Date		Conditional	When “Yes” to “Do you know when the merchant received the merchandise?”
What return method did you use?	Single Select	Face to Face FedEx DHL UPS Postal Service Other	Conditional
Please Explain:	Freeform Text		Conditional	When “Other” to “What return method did you use?”
What was the tracking number?	Freeform Text		Conditional	When either ”FedEx,” “DHL,” “UPS,” “Postal Service,” is selected to “What return method did you use?”
Did you attempt to resolve with the merchant?	Yes/No		Mandatory
Are there local laws or regulations prohibiting you from resolving with the merchant?	Yes/No		Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
Please explain.	Freeform Text		Conditional	When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No		Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”

― Service

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?
- No
- Yes
Is dispute related to the quality of food received from eating places or restaurants?
- No
- Yes
Please provide details of what was ordered and not as described.
When did you receive the service?
Did you cancel the service?
- No
- Yes —
  - When did you cancel?
  - Why did you cancel?
  - Did the merchant accept the cancellation?
    - No
    - Yes
Did you attempt to resolve with the merchant?
- No — Are there local laws or regulations prohibiting you from resolving with the merchant?
  - No
  - Yes — Please explain.
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Requirement level	Notes
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	Mandatory
Is dispute related to the quality of food received from eating places or restaurants?	Yes/No	Mandatory
Please provide details of what was ordered and not as described.	Freeform Text	Mandatory
When did you receive the service?	Date	Mandatory
Did you cancel the service?	Yes/No	Mandatory
When did you cancel?	Date	Conditional	When “Yes” to “Did you cancel the service?”
Why did you cancel?	Freeform Text	Conditional	Follows “When did you cancel?”
Did the merchant accept the cancellation?	Yes/No	Conditional	Follows “Why did you cancel?”
Did you attempt to resolve with the merchant?	Yes/No	Mandatory
Are there local laws or regulations prohibiting you from resolving with the merchant?	Yes/No	Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
Please explain.	Freeform Text	Conditional	When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No	Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text	Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”

The terms of sale were misrepresented.

Are you disputing the full amount of the transaction?
- No —
  - What amount are you disputing?
  - Why is the dispute different than the posted transaction amount?
- Yes
What was purchased?

― Merchandise

Please provide details of what was ordered.
When did you receive the merchandise/service?
How was the merchandise/service misrepresented?
Did you return the merchandise?
- No — Did you attempt to return the merchandise?
  - No
  - Yes —
    - When did you attempt to return it?
    - Please provide a detailed description of how you attempted to return the merchandise.
    - Where is the merchandise at this time?
    - Please select one of the options below which best represents the return attempt.
      - 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?
  - Do you know when the merchant received the merchandise?
    - No
    - Yes —
      - When did the merchant receive the merchandise?
      - What return method did you use?
        
        Face to Face
        
        FedEx — What was the tracking number?
        
        DHL — What was the tracking number?
        
        UPS — What was the tracking number?
        
        Postal Service — What was the tracking number?
        
        Other — Please explain:
Did you attempt to resolve with the merchant?
- No — Are there local laws or regulations prohibiting you from resolving with the merchant?
  - No
  - Yes — Please explain.
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Values	Requirement level	Notes
Please provide a description of what was ordered.	Freeform Text		Mandatory
When did you receive the merchandise/service?	Date		Mandatory
How was the merchandise/service misrepresented?	Freeform Text		Mandatory
Did you return the merchandise?	Yes/No		Mandatory
Did you attempt to return the merchandise?	Yes/No		Conditional	When “No” to “Did you return the merchandise?”
When did you attempt to return it?	Date		Conditional	When “Yes” to “Did you attempt to return the merchandise?”
Please provide a detailed description of how you attempted to return the merchandise.	Freeform Text		Conditional	Follows “When did you attempt to return it?”
Where is the merchandise at this time?	Freeform Text		Conditional	Follows “Please provide a detailed description of how you attempted to return the merchandise.”
Please select one of the options below which best represents the return attempt.	Single Select	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.	Conditional	Follows “Where is the merchandise at this time?”
When did you return the merchandise?	Date		Conditional	When “Yes” to “Did you return the merchandise?”
Do you know when the merchant received the merchandise?	Yes/No		Conditional	Follows “When did you return the merchandise?”
When did the merchant receive the merchandise?	Date		Conditional	When “Yes” to “Do you know when the merchant received the merchandise?”
What return method did you use?	Single Select	Face to Face FedEx DHL UPS Postal Service Other	Conditional
Please Explain:	Freeform Text		Conditional	When “Other” to “What return method did you use?”
What was the tracking number?	Freeform Text		Conditional	When either ”FedEx,” “DHL,” “UPS,” “Postal Service,” is selected to “What return method did you use?”
Did you attempt to resolve with the merchant?	Yes/No		Mandatory
Are there local laws or regulations prohibiting you from resolving with the merchant?	Yes/No		Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
Please explain.	Freeform Text		Conditional	When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No		Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”

― Service

Please provide a description of what was purchased.
When did you receive the service?
How was the merchandise/service misrepresented?
Did you cancel the service?
- No
- Yes —
  - When did you cancel?
  - Why did you cancel?
  - Did the merchant accept the cancellation?
    - No
    - Yes
Did you attempt to resolve with the merchant?
- No — Are there local laws or regulations prohibiting you from resolving with the merchant?
  - No
  - Yes — Please explain.
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Requirement level	Notes
Please provide a description of what was purchased.	Freeform Text	Mandatory
When did you receive the merchandise/service?	Date	Mandatory
How was the merchandise/service misrepresented?	Freeform Text	Mandatory
Did you cancel the service?	Yes/No	Mandatory
When did you cancel?	Date	Conditional	When “Yes” to “Did you cancel the service?”
Why did you cancel?	Freeform Text	Conditional	Follows “When did you cancel?”
Did the merchant accept the cancellation?	Yes/No	Conditional	Follows “Why did you cancel?”
Did you attempt to resolve with the merchant?	Yes/No	Mandatory
Are there local laws or regulations prohibiting you from resolving with the merchant?	Yes/No	Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
Please explain.	Freeform Text	Conditional	When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No	Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text	Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”

I was charged or credited incorrectly

How were you charged or credited incorrectly?

I was charged the wrong amount

Are you disputing the full amount of the transaction?
- 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.
What is the correct amount that should have been charged?
What is the amount shown on your receipt or confirmation?
Is the dispute due to the difference between the quoted price and the actual charges made by the merchant?
- No
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Requirement level	Notes
Are you disputing the full amount of the transaction?	Yes/No	Mandatory
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.		Conditional	When “Yes” to “Are you disputing the full amount of the transaction?”
What is the correct amount that should have been charged?	Freeform Text	Mandatory
What is the amount shown on your receipt or confirmation?	Freeform Text	Mandatory
Is the dispute due to the difference between the quoted price and the actual charges made by the merchant?	Yes/No	Mandatory
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No	Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text	Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”
Do you have any additional information to provide about this dispute?	Yes/No	Mandatory
Please provide any additional information.	Freeform Text	Conditional	When “Yes” to “Do you have any additional information to provide about this dispute?”

I was charged a long time after the transaction occurred

Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Requirement level	Notes
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No	Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text	Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”
Do you have any additional information to provide about this dispute?	Yes/No	Mandatory
Please provide any additional information.	Freeform Text	Conditional	When “Yes” to “Do you have any additional information to provide about this dispute?”

Invalid Data

Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Requirement level	Notes
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No	Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text	Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”
Do you have any additional information to provide about this dispute?	Yes/No	Mandatory
Please provide any additional information.	Freeform Text	Conditional	When “Yes” to “Do you have any additional information to provide about this dispute?”

Incorrect Currency

Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Requirement level	Notes
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No	Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text	Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”
Do you have any additional information to provide about this dispute?	Yes/No	Mandatory
Please provide any additional information.	Freeform Text	Conditional	When “Yes” to “Do you have any additional information to provide about this dispute?”

Incorrect Account Number

Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Requirement level	Notes
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No	Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text	Conditional	When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?”
Do you have any additional information to provide about this dispute?	Yes/No	Mandatory
Please provide any additional information.	Freeform Text	Conditional	When “Yes” to “Do you have any additional information to provide about this dispute?”

I was charged more than once.

The duplicate transaction must be selected for the claim reason Charged More Than Once.

Is the valid transaction on this same account?
- No — Is the other transaction on a Galileo card?
  - No — What was the other form of payment?
    - Another Visa
    - Another Card
    - Check
    - Cash
    - Other — Please explain.
  - Yes —
    - Select the account the charge(s) appear on:
    - Please select a valid transaction.
- Yes — Please select a valid transaction.
Did you attempt to resolve with the merchant?
- No — Are there local laws or regulations prohibiting you from resolving with the merchant?
  - No
  - Yes — Please explain.
- Yes
Do you have any additional information that should be provided to the merchant regarding your dispute?
- No
- Yes — Please provide any additional information. This will be provided to the merchant.
Do you have any additional information to provide about this dispute?
- No
- Yes — Please provide any additional information.

Question properties

Question	Type	Values	Requirement level	Notes
Is the valid transaction on this same account?	Yes/No		Mandatory
Please select a valid transaction.	Transaction Select		Conditional	When “Yes” to “Is the valid transaction on this same account?”
Is the other transaction on a Galileo card?	Yes/No		Conditional	When “No” to “Is the valid transaction on this same account?”
What was the other form of payment?	Single Select	Another Visa Another Card Check Cash Other	Mandatory	When “No” to “Is the other transaction on a Galileo card?”
Please explain.	Freeform Text		Mandatory	When “Other” to “What was the other form of payment?”
Select the account the charge(s) appear on:	Account Select		Conditional	When “Yes” to “Is the other transaction on a Galileo card?”
Please select a valid transaction.	Transaction Select		Conditional	When “Yes” to “Is the other transaction on a Galileo card?”
Did you attempt to resolve with the merchant?	Yes/No		Mandatory
Are there local laws or regulations prohibiting you from resolving with the merchant?	Yes/No		Conditional	When “No” to “Did you attempt to resolve with the merchant?”
Please explain.	Freeform Text		Conditional	When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?”
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No		Mandatory
Please provide any additional information. This will be provided to the merchant.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information to provide about this dispute?”
Do you have any additional information to provide about this dispute?	Yes/No		Mandatory
Please provide any additional information.	Freeform Text		Conditional	When “Yes” to “Do you have any additional information to provide about this dispute?”