DISPUTE FORM
Name PRAKASA RAO JAYANTHI
*Card Number 4317575024552912
*Mobile / Landline Number 08912500707/9866038452
*E-Mail Address [email protected]
Details of the Disputed Item (s)
*Transaction Date *Statement Date *Merchant Name *Transaction Amount *Disputed Amount
29/09/09 08/10/09 CTTSINGSPORECG442033938389 119.02USD 5911.53
02/10/09 07/10/09 Agehealth 420246019GB 119.02USD 5908.23
03/10/09 07/10/09 Skincaretoday 61280144926IE 119.02USD 5902.44
DECLARATION: I am disputing the transaction (s) listed above for the reason as follows:
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I have enclosed the following documents along with this form:
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2. %%%%%%%%%%%%%%__
3. %%%%%%%%%%%%%%__
DECLARATION
I hereby affirm that the information furnished above is true to the best of my knowledge.
My card was in my possession and control at the time of the questioned transactions.
Cardholder's Signature
Others (any additional comments)
*Cardholder's Signature %%%%%%%%%%%%%%__
All fields marked with * are Mandatory Fields
Dear Customer,
For us to serve you better please provide us with the additional documents as listed depending on the nature of the dispute. Incase the concern you are raising doesn’t pertain to the listed criteria you are requested to fill up Page 1 only.
Nature of Dispute Documents Required
ATM Cash Not Received or Partial amount received Copy of the ATM slip
Paid for Goods by Other Means- Cash Memo/Bank Statement/Payment Counterfoil/Card Statement.
Non-Receipt of Goods or Services
Copy of Letter to the merchant attempting to resolve the dispute.
Credit Not Processed Copy of Credit /Refund Slip/ Cancellation letter from merchant establishment.
Difference in billed Amount Copy of Charge slip showing the actual amount.
Unauthorized Transaction (s). Copy of charge slip for the genuine transaction.
All fields marked with * are Mandatory Fields. This form is invalid without Signatures.
Please sign the form & send it to…
Mail at- [email protected]
Courier - Chargeback Department
10th Floor Tower-C, DLF Infinity Towers,
Block-2
Gurgaon, 122002
Fax- 0124-3992476
On 12th october I received one parcel from Tradingplant, The coach house, Unin street, BS-27, 3 N.A, UNITED KINGDOM. I did not taken the parcel I refused the parcel. i saw a phone number at the top of the parcel it is 0011-2031399027 and 001108082389891 I contacted the phone number but no reply for the phone. I did not ordered any material how the parcel came sir.
I request you to kindly consider my case and do justice. I did not ordered why should I suffer in mental and financial sir. Reply soon.
J PRAKASA RAO
Back
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MONTHLY STATEMENT
SBI Card
Full Name Card Number Statement Date Page
J P RAO 07 October 1 of 1
Credit Limit (Rs.)
(including cash) 33000.00
Available Credit (Rs.) (including Cash) 7175.54
Cash Limit (Rs.) (as a part of credit limit) 13200.00
Available Cash (Rs.). 7175.54
PAYMENT DUE DATE
27 October
* MINIMUM AMOUNT DUE (Incl. GST in Rs.)
1339.35
** TOTAL AMOUNT DUE (Rs.)
25824.46 D
Date Description Amount (Rs.)
Transaction for card number 2912
09/09 IRCTC LTD NEW DELHI IN 290.13 D
09/09 IRCTC LTD NEW DELHI IN 290.13 D
09/09 IRCTC LTD NEW DELHI IN 299.29 D
11/09 IRCTC LTD NEW DELHI IN 239.23 C
17/09 BSNL PAYMENTS MUMBAI IN 923.00 D
17/09 PAYMENT RECEIVED CHEQUE NO 107728 10000.00 C
29/09 CTT 442033938389 SINGAPORE SG 119.02 USD 5911.53 D
02/10 AgeHealth 42 024 601 9 GB 119.02 USD 5908.23 D
03/10 Skincare Today 61280144926 IE 119.02 USD 5902.44 D
Transaction for the account
07/10 TOTAL GST DEBIT FOR CURRENT STMT 50.66 D
07/10 FIN CHARGE ON RETAIL (EXCL GST 50.66) 491.82 D
* The Minimum Amount Due includes 100% of Government service Tax (GST). # C = Credit;D = Debit; EN = Encash; FP = Flexipay; * Contents of this will be considered correct if no errors reported within 20 days.
* In order to keep your credit card in good standing, you have the option of paying at least the Minimum Amount Due or any amount between the Minimum Amount Due and Total Amount Due, on or beforethe due date.
** Amount required to be paid this month in order to avoid levying of finance charges.
Account Summary
Opening Balance (Rs.) 15996.46 D
Purchase & Other debits (Rs.) 20067.23
- Payments, Reversals & Other credits (Rs.) 10239.23
= Total Outstanding (Rs.) 25824.46 D
Reward Points Summary
Opening Balance 1406
Points Earned 766
- Points Redeemed 0
= Closing Balance 2172
Please draw your cheque favoring 'SBI Card No.xxxx xxxx xxxx xxxx' and ensure that you fill your name and telephone no. at the back of the cheque and drop it in the drop box at the nearest State Bank branch or else mail it to SBICPSL, P.O. Bag No. 24, GPO, New Delhi 110001 by ordinary mail.
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Back
. .
MONTHLY STATEMENT
SBI Card
Full Name Card Number Statement Date Page
J P RAO 07 September 1 of 1
Credit Limit (Rs.)
(including cash) 33000.00
Available Credit (Rs.) (including Cash) 17003.54
Cash Limit (Rs.) (as a part of credit limit) 13200.00
Available Cash (Rs.). 13200.00
PAYMENT DUE DATE
27 September
* MINIMUM AMOUNT DUE (Incl. GST in Rs.)
854.70
** TOTAL AMOUNT DUE (Rs.)
15996.46 D
Date Description Amount (Rs.)
Transaction for card number 2912
11/08 BSNL PAYMENTS MUMBAI IN 441.00 D
13/08 Indian Railways Cateri DEL IN 510.00 C
13/08 Indian Railways Cateri DEL IN 878.00 C
14/08 ETS*GRE CBT REGISTRATI 609-771-7670 NJ 50.00 USD 2505.91 D
15/08 TIRUMALA TIRUPATI DEVA TIRUPATI IN 100.00 D
18/08 TIRUMALA TIRUPATI DEVA TIRUPATI IN 100.00 D
18/08 INDIAN RAILWAY CATERIN NEW DELHI IN 1337.65 D
18/08 INDIAN RAILWAY CATERIN NEW DELHI IN 1337.65 D
18/08 PAYMENT RECEIVED CHEQUE NO 107727 10000.00 C
24/08 FOCUSCLEANSE 3618088234 CY 5.97 USD 302.31 D
28/08 IRCTC LTD NEW DELHI IN 881.58 D
28/08 MM-BILLITSECURE.COM 44 203139903 GB 3.51 USD 178.39 D
28/08 IRCTC LTD NEW DELHI IN 881.58 D
Transaction for the account
07/09 TOTAL GST DEBIT FOR CURRENT STMT 57.77 D
07/09 FIN CHARGE ON RETAIL (EXCL GST 57.77) 560.91 D
* The Minimum Amount Due includes 100% of Government service Tax (GST). # C = Credit;D = Debit; EN = Encash; FP = Flexipay; * Contents of this will be considered correct if no errors reported within 20 days.
* In order to keep your credit card in good standing, you have the option of paying at least the Minimum Amount Due or any amount between the Minimum Amount Due and Total Amount Due, on or beforethe due date.
** Amount required to be paid this month in order to avoid levying of finance charges.
Account Summary
Opening Balance (Rs.) 18699.71 D
Purchase & Other debits (Rs.) 8684.75
- Payments, Reversals & Other credits (Rs.) 11388.00
= Total Outstanding (Rs.) 15996.46 D
Reward Points Summary
Opening Balance 610
Points Earned 796
- Points Redeemed 0
= Closing Balance 1406
Please draw your cheque favoring 'SBI Card No.xxxx xxxx xxxx xxxx' and ensure that you fill your name and telephone no. at the back of the cheque and drop it in the drop box at the nearest State Bank branch or else mail it to SBICPSL, P.O. Bag No. 24, GPO, New Delhi 110001 by ordinary mail.
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