Debit Card Dispute Form

Debit Card Dispute

"*" indicates required fields

Step 1 of 5

20%

Operations Department

Member Details

Member's Name
Address*

Kindly select all that applies:

Card Status*
Did you give your Debit card to another person?*
Do you keep your Debit card in a location easily accessible by other individuals?*
Did you authorize the use of your Debit card by another person?*
Did you share your Personal Identification Number (PIN) with another person?*
Have you stored your debit card details on your cellphone, tablet, computer or browser?*
Have you ever stored your Debit Card details on any other electronic device?*
When making a purchase, is it always done on your personal device?*
Do you receive alerts via email and/or text message whenever you do a transaction?*
Have you recently changed your email address or telephone number?*
Did you inform JPCCU of the change?*
Have you recently cancelled a subscription?*
Do you use your JPCCU card to make online purchases?*
Did you report the matter to the Police Fraud Squad?*

Kindly List All Transaction (s) Being Disputed:

List*
Transaction Date
Trace#
Transaction amount (JM)
Transaction Amount (FX)
Transaction Location
Transaction Type (ATM POS/Online)
Authorization ID
 

Update Information If Differs on Core Banking System or File

PLEASE SELECT REASON FOR DISPUTING TRANSACTION(S)

Duplicate Charge – My account was debited more than once for the same goods or services*
Incorrect amount charged?*
Transaction amount:*
Incorrect Transaction amount
Correct Transaction amount
 
ATM cash was NOT received – Cash not dispensed*
Partial amount dispensed by ATM*
Transaction amount:*
Requested amount
Received amount
 
Goods or services were NOT as described or defective*
Goods or services were NOT provided*
Expected delivery date of goods or services was*
Paid for goods by other means*
Drop files here or
Accepted file types: jpg, gif, png, pdf, Max. file size: 1 GB, Max. files: 2.
    Recurring transaction cancelled prior to billing*
    Cancellation Date*
    Billed for “No-Show” charge after cancellation*
    Cancellation Date*
    My card was lost/stolen*
    Lost/stolen date*
    Reported to member services on this date*
    Fraudulent/unauthorized transaction(s)*
    I did not participate in or authorize the transaction(s). My card has been in possession at all times. I understand that in order to process a fraudulent transaction my card will be cancelled, pending the outcome of the investigation.
    Drop files here or
    Max. file size: 1 GB, Max. files: 2.
      Upload copy of ID and Police Report
      List ATM/Point of Sale (POS) machines frequently used:*
      ATM/POS Location(s)
      Address of Location(s)
       
      Drop files here or
      Max. file size: 1 GB.
        List of E-Commerce sites frequently used:*
        (Provide a brief statement on the matter)
        Declaration for Unauthorized transaction(s)*
        Date*

        Debit Card Cancellation Agreement

        I/We confirm that the following debit card will be destroyed upon completion of this form.*
        Date*
        This field is for validation purposes and should be left unchanged.

        We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. By clicking “Accept All”, you consent to the use of ALL the cookies. However, you may visit "Cookie Settings" to provide a controlled consent.
        Cookie SettingsAccept All
        Manage consent

        Privacy Overview

        This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience.
        Necessary
        Always Enabled
        Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
        Non-necessary
        Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.
        SAVE & ACCEPT

        Login

        Forgotten Password?

        Lost your password?
        | Back to Login