Balance Transfer Questionnaire

| Which of the following best describes the reason for your dispute? | Claim Reason |
|---|---|
| I did not authorize this transaction. I suspect fraud. | Fraud |
| I authorized this balance transfer, but it is incorrect. | Incorrect |
I did not authorize this transaction. I suspect fraud.

Do you recognize the account where the balance transfer originated?
Yes or No
Please describe in detail the reason for your dispute.
Free-form text box
Would you like us to send you a replacement card?
Do you have any additional information to provide about this dispute?
I authorized this balance transfer, but it is incorrect.

Please describe in detail the reason for your dispute.
Free-form text box
Do you have any additional information to provide about this dispute?





