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

I made this payment, but there is a problem and I need to dispute it.

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

The payment was processed on the wrong date or for the wrong amount.

Question	Type	Mandatory/Optional/Conditional	Notes
What date should the payment have been sent?	Date	Mandatory
What was the expected payment amount?	Freeform Text	Mandatory
Was the payment sent late?	Yes/No	Mandatory
Is this dispute in regards to a fee charged by the payee?	Yes/No	Conditional	When “Yes” to “Was the payment sent late?”
What was the amount of the fee?	Freeform Text	Conditional	When “Yes” to “Is this dispute in regards to a fee charged by the payee?”
Do you have proof or documentation of the fee?	Yes/No	Conditional	Follows “What was the amount of the fee?”
Please describe in detail the reason for your dispute.	Freeform Text	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?”

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

The payee did not receive the funds.

Question	Type	Mandatory/Optional/Conditional	Notes
Who was the intended recipient of the payment?	Freeform Text	Mandatory
What account number should the payment have been sent to?	Freeform Text	Mandatory
What address should the check have been sent to?	Freeform Text	Mandatory
Did you contact the payee?	Yes/No	Mandatory
Please describe in detail the reason for your dispute.	Freeform Text	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?”

Bill Pay Questionnaires

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