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How were you charged or credited incorrectly?

I was charged the wrong amount

Question	Type	Mandatory/Optional/Conditional	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
Did you attempt to resolve with the merchant?	Yes/No	Mandatory
Please explain:	Freeform Text	Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
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?”

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How were you charged or credited incorrectly?

I should have received a credit but was charged again

Question	Type	Mandatory/Optional/Conditional	Notes
Did you attempt to resolve with the merchant?	Yes/No	Mandatory
Please explain:	Freeform Text	Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
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?”

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How were you charged or credited incorrectly?

I was charged more than 180 days after I authorized the transaction

Question	Type	Mandatory/Optional/Conditional	Notes
When was the transaction authorized?	Date	Mandatory
Is the account the transaction authorized on closed?	Yes/No	Mandatory
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?”

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How were you charged or credited incorrectly?

I was charged for a "No-Show" from a hotel incorrectly

Question	Type	Mandatory/Optional/Conditional	Notes
Were the accommodations used?	Yes/No	Mandatory
Did the merchant provide alternate accommodations and still charge for a “no-show”?	Yes/No	Mandatory
Was the “no-show” charge different from the quoted rate?	Yes/No	Mandatory
What was the quoted rate?	Freeform Text	Conditional	When “Yes” to “Was the “no-show” charge different from the quoted rate?”
Did you cancel?	Yes/No	Mandatory
When did you cancel?	Date	Conditional	When “Yes” to “Did you cancel?”
Why did you cancel?	Freeform Text	Conditional	Follows “When did you cancel?”
How did you cancel?	Freeform Text	Conditional	Follows “Why did you cancel?”
Was a cancellation policy provided?	Yes/No	Conditional	Follows “How did you cancel?”
What was the policy?	Freeform Text	Conditional	Follows “Was a cancellation policy provided?”
Did you attempt to resolve with the merchant?	Yes/No	Mandatory
Please explain:	Freeform Text	Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
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?”

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How were you charged or credited incorrectly?

I was charged for loss, theft, or damages in addition to the service

Question	Type	Mandatory/Optional/Conditional	Notes
Are you disputing the full amount of the transaction?	Yes/No	Mandatory
What amount are you disputing?	Freeform Text	Conditional	When “Yes” to “Are you disputing the full amount of the transaction?”
Is the dispute regarding additional charges related to damages?	Yes/No	Mandatory
Is the dispute regarding additional charges related to theft or loss of a rental?	Yes/No	Conditional	When “No” to “Is the dispute regarding additional charges related to damages?”
Were the additional charges and the service charge billed as a single transaction?	Yes/No	Mandatory
Please provide additional information on the reason of the additional charges:	Freeform Text	Mandatory
Did you attempt to resolve with the merchant?	Yes/No	Mandatory
Please explain:	Freeform Text	Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
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?”

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indexInGroup	6
tabsPageTitle	Second, Unauthorized ChargeAddendum
colorPalettes	Default
color	#0052CC
textAlignment	left
id	ws3fbe125djhctfj9j12b

How were you charged or credited incorrectly?

I authorized a purchase, but a second, unauthorized transaction was processed

Question	Type	Mandatory/Optional/Conditional	Notes
Please describe the additional charge and why it is not authorized:	Freeform Text	Mandatory
Did you attempt to resolve with the merchant?	Yes/No	Mandatory
Please explain:	Freeform Text	Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
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?”

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How were you charged or credited incorrectly?

I did not receive the cash-back portion of my transaction

Question	Type	Mandatory/Optional/Conditional	Notes
Are you disputing the full amount of the transaction?	Yes/No	Mandatory
To dispute a cash-back transaction, 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 amount was not provided to you?	Freeform Text	Mandatory
Did you attempt to resolve with the merchant?	Yes/No	Mandatory
Please explain:	Freeform Text	Conditional	When “Yes” to “Did you attempt to resolve with the merchant?”
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?”

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