Transaction Dispute Form / Written Statement of Unauthorized Debit. Please complete and print this form if you are disputing a charge from a merchant that has posted to your card. Please include a copy of all supporting documentation such as transaction receipts and correspondence with the merchant. Email this form and any additional documents to

This form must be completed and submitted as soon as a suspected fraudulent card transaction is identified. Transaction Dispute forms must be received within 120 calendar days from original transaction(s) date.

Please complete all sections of the form (as applicable). If you have not done so already, you may also call us (see the back of your card OR the ‘Contact Us’ section on our website for our Customer Support phone number) during business hours to file your dispute directly with us.

atm/debit card dispute form Complete this form to report (a) the unauthorized use of your ATM/debit card, (b) a point-of-sale (POS) transaction error or dispute, or (c) an incorrect disbursement of cash by an ATM.

Request you to resolve the dispute. I have neither authorized nor participated in the above transaction(s). The card was in my possession at all times. I authorize SBI Card to block my credit card as per the Visa / Mastercard / RuPay / Amex norms.

Please complete and print this form if you are disputing a charge from a merchant that has posted to your account. Please include a copy of all supporting documentation such as transaction receipts and

contacting the merchant directly to assist in resolving your dispute. Check reason for dispute. If needed, include any relevant documents such as receipts or shipping confirmations.

Please select one dispute reason from the list below and completely answer all questions. Please complete and sign, then forward to Citibank® and the Program Administrator/Agency Oficial (as determined by your internal procedures), within 60 days of the statement date on which the disputed transaction posted so that we may investigate.

If you believe that a transaction(s) on your account is in error or unauthorized, you can use this form to dispute the transaction(s) in question. Please complete this form and provide any supporting documentation you may have to help facilitate our investigation.

Complete and return this form to dispute a signature-based Citibank ® Debit MasterCard transaction. If you do not have a case number, first contact Customer Service at (800) 647-5344, option 1. For any other types of inquires or disputes, contact CitiPhone at (888) 248-4226.