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    Dispute Form: Transaction Date Statement Date Transaction Description Amount (RM)

    Uploaded by

    Asrul Awg
    This dispute form allows a customer to dispute one or more transactions on their credit card statement, including the transaction details, reason for dispute, and a declaration authorizing the bank to investigate. The customer provides their contact information and signature and can submit the form by email or mail to the bank within 20 days of the statement closing date.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Dispute Form: Transaction Date Statement Date Transaction Description Amount (RM)

    Uploaded by

    Asrul Awg
    79 views1 page
    This dispute form allows a customer to dispute one or more transactions on their credit card statement, including the transaction details, reason for dispute, and a declaration authorizing the bank to investigate. The customer provides their contact information and signature and can submit the form by email or mail to the bank within 20 days of the statement closing date.

    Original Description:

    maybank

    Original Title

    CC-DisputeForm

    Copyright

    © © All Rights Reserved

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    This dispute form allows a customer to dispute one or more transactions on their credit card statement, including the transaction details, reason for dispute, and a declaration authorizing the bank to investigate. The customer provides their contact information and signature and can submit the form by email or mail to the bank within 20 days of the statement closing date.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    79 views1 page

    Dispute Form: Transaction Date Statement Date Transaction Description Amount (RM)

    Uploaded by

    Asrul Awg
    This dispute form allows a customer to dispute one or more transactions on their credit card statement, including the transaction details, reason for dispute, and a declaration authorizing the bank to investigate. The customer provides their contact information and signature and can submit the form by email or mail to the bank within 20 days of the statement closing date.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Date:

    DISPUTE FORM
    Cardnumber:
    CASA number:

    I/We hereby dispute the following transaction(s) :-


    Transaction Description Statement Date Transaction Date Amount (RM)

    TOTAL

    Reason(s) for dispute and enclose supporting document(s) where applicable:-

    I/We request a Sales Draft copy for reference (A fee of RM15.00 will be levied).

    The above charge(s) was/were neither made nor authorized by me/supplementary cardholder. The card was in my/supplementary
    cardholder's possession at the time of the above transaction.
    I/We participated ________________(times) transaction(s) amounting to ____________ but was/were billed ______________
    (amount).
    Amount charged differs. I/We authorised ____________ (amount) but amount debited was _____________ (amount). *Enclose proof
    of payment.
    I/We has/have paid the charge by cash/cheque/other credit card/charge card/debit card. *Enclose proof of payment.

    I/We have not received the merchandise/service for the transaction billed above. The expected delivery of merchandise/service was
    __________ (date). *Proof of sales invoice with date of delivery.

    I/We have cancelled the above transaction on _____________ (date). *Enclose proof of cancellation.

    Credit voucher issued by merchant was not posted into my/supplementary cardholder's account. *Enclose copy of voucher/invoice.

    I/We cancelled the reservation with the above hotel on ___________ (date) and the cancellation code is ________________. *Enclose
    proof of cancellation.

    Other (please specify):_________________________________________________________________

    1) I/We hereby authorize Malayan Banking Berhad (the 'Bank') to investigate/correct the transaction(s) in dispute.
    2) I/We hereby acknowledge that upon initial investigation of the disputed transaction, the Bank may at its sole and absolute discretion credit
    the monies into my/our account being goodwill payment (the ‘Sum’) for my/our claim on the unauthorised transaction pending the finalisation
    of the Bank’s investigation on my/our claim without admission of any liability whatsoever on the part of the Bank as to my/our claim.
    3) I/We further acknowledge that in the event the Bank’s investigation proves otherwise, in which the payment of the Sum would not be
    required, I/we hereby acknowledge that the Bank shall exercise its right to set off the Sum standing in credit of any or all of my/our banking
    accounts towards satisfaction of the said Sum.

    Declaration:
    I/We hereby agree that upon resolution of the dispute and/ or refund of the said sum, the Bank shall be discharged from all liabilities and I/we
    further agree that the Bank shall not be responsible for and I/we shall fully indemnify the Bank and hold the Bank harmless against all losses,
    costs and expenses which may be incurred by me/us or by the Bank howsoever arising in connection with the transfer made by me and any
    subsequent refund of the said sum. This indemnity is irrevocable until such time the Bank revokes the same. I/We hereby undertake that I/we
    shall not make any further claim for compensation or damages whatsoever in connection with the transfer made by me and any subsequent
    refund of the said sum’.

    Signature: For submission:


    ● Email to: disputemgmt@maybank.com.my
    ● Mail to: Maybank Card Centre,
    Name: 100, Jalan Menara
    7th Floor, Tun Perak,
    Maybank,
    IC No: 50050 Kuala Lumpur.

    Contact No:

    Email add: Kindly submit this form to us within 20 days from closing date of
    billing period else we will assume the charge(s) is in order.

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