Debit Card Dispute

Individual Information

I am disputing the following transactions(s) for the reason given below.

Details of Disputed Items

If you have additional transactions please call 1.800.422.3372

At the time of the transaction(s), were you in possession of your card?
Please select the most appropriate ONE

I did not authorize this transaction/these transactions.

I have done only one transaction at the merchant, but I was charged the below amount of times

I did not receive merchandise on the expected date below. Please provide detailed description of merchandise/service


I declare that the above information is true and correct to my knowledge. I understand that I can be held liable for all charges incurred if dispute raised by me is found invalid during the investigation. First Federal Savings Bank may contact me whenever it requires any further information.

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