This article explains how to complete and submit the Cardholder Dispute Form so our team can review your dispute request and guide you on the next steps.
Use this form if you want to dispute a card transaction, such as an unrecognised payment, duplicate charge, failed transaction, refund not received, cancelled subscription, or goods/services issue.
You can download the dispute form here: Cardholder_Dispute_Form.docx
Step 1: Fill in the card details
In the Card Number field, enter only the last 4 digits of the card used for the transaction. Please do not enter the full card number.
Step 2: Add the transaction details
In the transaction table, fill in the details of the transaction you want to dispute:
S. No.: 1, 2, 3, etc.
Transaction Date
Name of Merchant
Transaction Amount
If you are disputing more than one transaction, add each transaction on a separate line.
Step 3: Select the dispute reason
Tick the reason that best matches your issue. For example:
If your issue is | Select this reason on the form |
You do not recognise the transaction | Transaction not recognised |
You did not authorise an online, phone, or mail order transaction | Unauthorised Internet / Mail / Phone order transaction |
The payment failed, was incomplete, or was not authorised, but you were still charged | Incomplete / Failed / Not authorised |
You were charged more than once for the same purchase | Duplicate transaction |
You made one valid payment, but another transaction from the same merchant is incorrect | Incurred one transaction, but not the listed transaction |
You were charged a different amount from what you agreed to pay | Amount incurred was different from amount billed |
You paid for goods or services but did not receive them | Service / Goods not received |
The merchant confirmed a refund, but you have not received it | Credit voucher / refund not processed |
You cancelled a recurring membership or subscription, but were charged again | Cancelled recurring Membership / Subscription |
You cancelled a hotel booking, but were charged a no-show fee | Hotel reservation cancelled but billed for “no show” charge |
You paid the merchant another way, but your card was still charged | Paid the amount by other means |
None of the listed reasons match your issue | Other Dispute Reasons |
Step 4: Add any extra details requested
Some dispute reasons ask for extra information. For example:
If you were charged the wrong amount, mention the amount you expected to be charged.
If you cancelled a subscription, add the cancellation date.
If a refund was promised, add the refund or credit voucher date.
If you cancelled a hotel booking, add the cancellation date and cancellation number.
If you paid another way, mention how you paid.
Fill in only the fields that are relevant to your dispute reason.
Step 5: Attach supporting documents
Please attach any documents or screenshots that support your dispute.
This may include:
Receipt or invoice
Merchant email or chat
Cancellation confirmation
Refund confirmation
Proof of alternate payment
Order or delivery details
Screenshots showing the issue
Supporting documents help our team review your case faster and may be required for some dispute categories.
Step 6: Sign and submit the form
At the end of the form, the cardholder must fill in:
Name
Contact Number
Signature
Date
You can sign the form in either of these ways:
Print the form, sign it by hand, scan it, and send it back as a PDF or image; or
Add a digital signature and send the completed form as a PDF or image.
Once completed, email the signed form and any supporting documents to:
Please make sure the form is completed and signed before sending it. Incomplete or unsigned forms may not be processed.