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Which of the following would you like to report?

I have an issue with a convenience check.

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Credit Card only

View file

name	Convenience Check Questionnaires.pdf

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Which of the following best describes the reason for your dispute?

I did not participate in this transaction, and I did not authorize anyone else to participate in this transaction.

Question	Type	Mandatory/Optional/Conditional	Notes
Have you ever done business with any of the merchants involved in the fraudulent transactions?	Yes/No	Mandatory
Were any checks recently lost or stolen?	Yes/No	Mandatory
Was anything else lost or stolen?	Yes/No	Conditional	When “Yes” to “Were any checks recently lost or stolen?”
Please describe what else was lost or stolen	Freeform Text	Conditional	When “Yes” to “Was anything else lost or stolen?”
Did you recently order checks?	Yes/No	Mandatory
Were the checks received?	Yes/No	Conditional	When “Yes” to “Did you recently order checks?”
Have you ever authorized anyone to use the checks?	Yes/No	Conditional	When “Yes” to “Were the checks received?”
Who was authorized to use the checks?	Freeform Text	Conditional	When “Yes” to “Have you ever authorized anyone to use the checks?”
Have you confirmed that this transaction was not made by the authorized person?	Yes/No	Conditional	Follows “Who was authorized to use the checks?”
Have you ever authorized anyone to use your online banking account?	Yes/No	Mandatory
Who did you give authorization to use your online banking?	Freeform Text	Conditional	When “Yes” to “Have you ever authorized anyone to use your online banking account?”
Have you ever shared your online banking credentials?	Yes/No	Mandatory
Who did you share your online banking credentials with?	Freeform Text	Conditional	When “Yes” to “Have you ever shared your online banking credentials?”

Due to the fraud on your account, we are cancelling your card.

Question	Type	Mandatory/Optional/Conditional	Notes
Would you like us to send you a replacement card?	Yes/No	Mandatory
No new card will be issued at this time. If you change your mind, please contact customer service or visit your local banking center to request a new card.		Conditional	When “No” to “Would you like us to send you a replacement card?”
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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Which of the following best describes the reason for your dispute?

I authorized the convenience check but there was an issue and I need to dispute it.

Question	Type	Mandatory/Optional/Conditional	Notes
Have you attempted to resolve the issue with the recipient?	Yes/No	Mandatory
Did the convenience check post for the incorrect amount?	Yes/No	Mandatory
What was the correct amount?	Freeform Text	Conditional	When “No” to “Did the convenience check post for the incorrect amount?”
Was the Convenience Check used to pay for merchandise or a service that you did not receive?	Yes/No	Mandatory
Please describe what was purchased and any additional details about the transaction that will help us investigate your dispute.	Freeform Text	Conditional	When “Yes” to “Was the Convenience Check used to pay for merchandise or a service that you did not receive?”
Please describe in detail what was incorrect about the convenience check.	Freeform Text	Mandatory
Do you have any additional information that should be provided to the merchant regarding your dispute?	Yes/No	Mandatory
Do you have any additional information to provide about this dispute?	Yes/No	Mandatory

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