Which of the following would you like to report?
I participated in this transaction, but there is a problem.
Which of the following best describes the reason for your dispute?
I have not received the merchandise or services that I purchased.
Question | Type | Values | 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?” | |
Why is the dispute different than the posted transaction amount? | Freeform Text | Conditional | Follows “What amount are you disputing?” | |
Is the purchase a third-party gift card without an expiration date, where the merchandise or services were not provided by the third party due to insolvency or bankruptcy? | Yes/No | Mandatory | ||
What was not received? | Single Select | Merchandise Service | Mandatory | |
Please provide a detailed description of what was purchased and an explanation of the dispute. | Freeform Text | Mandatory |
Merchandise
Question | Type | Values | Mandatory/Optional/Conditional | Notes |
|---|---|---|---|---|
Did the merchant cancel the merchandise? | Yes/No | Mandatory | ||
Date merchant cancelled merchandise | Date | Conditional | When “Yes” to “Did the merchant cancel the merchandise?” | |
Is the merchant in bankruptcy or liquidation? | Yes/No | Mandatory | ||
Are you still expecting a delivery for the merchandise? | Yes/No | Mandatory | ||
What is the last expected receipt date for the merchandise? | Date | Mandatory | ||
Why are you initiating a dispute prior to the expected delivery date? | Freeform Text | Conditional | When “Yes” to “Are you still expecting a delivery for the merchandise?” | |
What was the expected receipt time for the merchandise? | Freeform Text | Mandatory | ||
Was the merchandise delivered to the incorrect location? | Yes/No | Mandatory | ||
Please provide the address of the agreed upon location. | Freeform Text | Conditional | When “Yes” to “Was the merchandise delivered to the incorrect location?” | |
Was the merchandise delivered late? | Yes/No | Mandatory | ||
Please provide details of late delivery. | Freeform Text | Conditional | When “Yes” to “Was the merchandise delivered late?” | |
Did you return the merchandise? | Yes/No | Conditional | Follows “Please provide details of late delivery.” | |
Did you attempt to return the merchandise? | Yes/No | Conditional | When “No” to “Was the merchandise delivered late?” | |
When did you attempt to return it? | Date | Conditional | When “Yes” to “Did you attempt to return the merchandise?” | |
When did you return the merchandise? | Date | Conditional | When “Yes” to “Was the merchandise delivered late?” | |
Do you know when the merchant received the merchandise? | Yes/No | Conditional | Follows “When did you return the merchandise?” | |
When did the merchant receive the merchandise? | Date | Conditional | When “Yes” to “Do you know when the merchant received the merchandise?” | |
What return method did you use? | Single Select | Face to Face FedEx DHL UPS Postal Service Other | Conditional | |
Please Explain: | Freeform Text | Conditional | When “Other” to “What return method did you use?” | |
What was the tracking number? | Freeform Text | Conditional | When either ”FedEx,” “DHL,” “UPS,” “Postal Service,” is selected to “What return method did you use?” | |
Did you cancel prior to the expected receipt date? | Yes/No | Mandatory | ||
When did you cancel? | Date | Conditional | When “Yes” to “Did you cancel prior to the expected receipt date?” | |
Did you attempt to resolve with the merchant? | Yes/No | Mandatory | ||
Are there local laws or regulations prohibiting you from resolving with the merchant? | Yes/No | Conditional | When “No” to “Did you attempt to resolve with the merchant?” | |
Please explain. | Freeform Text | Conditional | When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?” | |
Do you have any additional information that should be provided to the merchant regarding your dispute? | Yes/No | Mandatory | ||
Please provide any additional information. This will be provided to the merchant. | Freeform Text | Conditional | When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?” | |
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?” |
Service
Question | Type | Values | Mandatory/Optional/Conditional | Notes |
|---|---|---|---|---|
Did merchant cancel services? | Yes/No | Mandatory | ||
Date the merchant cancelled services | Date | Conditional | When “Yes” to “Did merchant cancel services?” | |
Is the merchant in bankruptcy or liquidation? | Yes/No | Mandatory | ||
Was non-fiat currency (e.g. cryptocurrency) or non-fungible token(s) not successfully delivered to the destination wallet address supplied by the Cardholder at the time of the Transaction? | Yes/No | Mandatory | ||
Note: Please provide evidence that the non-fiat currency or non-fungible token(s) was not successfully delivered to the destination wallet address at the time of the Transaction. | Conditional | When “Yes” to “Was non-fiat currency (e.g. cryptocurrency) or non-fungible token(s) not successfully delivered to the destination wallet address supplied by the Cardholder at the time of the Transaction?” | ||
Are you still expecting a service delivery? | Yes/No | Mandatory | ||
What is the last expected receipt date for the service? | Date | Mandatory | ||
Why are you initiating a dispute prior to the expected delivery date? | Freeform Text | Conditional | When “Yes” to “Are you still expecting a service delivery?” | |
What was the expected receipt time for the service? | Freeform Text | Mandatory | ||
Did you cancel the service prior to the expected receipt date? | Yes/No | Mandatory | ||
When did you cancel? | Date | Conditional | When “Yes” to “Did you cancel prior to the expected receipt date?” | |
Why did you cancel? | Freeform Text | Conditional | Follows “When did you cancel?” | |
Did you attempt to resolve with the merchant? | Yes/No | Mandatory | ||
Are there local laws or regulations prohibiting you from resolving with the merchant? | Yes/No | Conditional | When “No” to “Did you attempt to resolve with the merchant?” | |
Please explain. | Freeform Text | Conditional | When “Yes” to “Are there local laws or regulations prohibiting you from resolving with the merchant?” | |
Do you have any additional information that should be provided to the merchant regarding your dispute? | Yes/No | Mandatory | ||
Please provide any additional information. This will be provided to the merchant. | Freeform Text | Conditional | When “Yes” to “Do you have any additional information that should be provided to the merchant regarding your dispute?” | |
Do you have any additional information to provide about this dispute? | Yes/No | Mandatory |