Mastercard Charged for Loss Theft Damages Questionnaire



Charged for Loss, Theft or Damages


Dispute Amount

Question

Property

Type

Values

Mandatory/Optional/Conditional

Notes

Are you disputing the full amount of the transaction?DisputingFullAmountYes/No
Mandatory

What amount are you disputing?

DifferentDisputeAmountText
Mandatory if DisputingFullAmount="No"

Question

Property

Type

Values

Mandatory/Optional/Conditional

Notes

Is the dispute regarding additional charges related to damages?DamageChargesIndYes/No
Mandatory
Is the dispute regarding additional charges related to theft or loss of a rental?RentalTheftLossIndYes/No
Mandatory if DamageChargesInd="No"

Dispute rights do not exist under this dispute reason. Please select another dispute reason.




Displayed if RentalTheftLossInd="No"
Were the additional charges and the service charge billed as a single transaction?LossTheftSingleTxnIndYes/No
Mandatory
Please provide additional information on the reason of the additional charges:AdditionalChargesExplanationText
Mandatory


Resolve with Merchant

Question

Property

Type

Values

Mandatory/Optional/Conditional

Notes

Did you attempt to resolve with the merchant?ResolveWithMerchantIndYes/No
Mandatory
Please explain:ResolveWithMerchantExplanationText
Mandatory if ResolveWithMerchantInd="Yes/No"


Additional Information

Question

Property

Type

Values

Mandatory/Optional/Conditional

Notes
Do you have any additional information to provide about this dispute?AdditionalInformationIndYes/No
Mandatory
If you have any documentation in support of your claim, please attach it now.N/AAttachment
Optional

Extension: Intake Attachment Prompt

To prompt users to attach any available documentation during intake, set CanAttachIntakeDocs to true.

Please provide any additional information.AdditionalInformation

Mandatory if AdditionalInformationInd= "Yes"