Personalize the form letter below by entering your specifics in the CAPITALIZED areas. 


DATE


BILLING INQUIRIES DEPARTMENT
CREDIT CARD COMPANY NAME
COMPANY'S ADDRESS
CITY, STATE AND ZIP CODE

Re: Disputed charge on CARD NAME account NUMBER

Dear Sir or Madam:

On my most recent credit card statement, which closed on DATE and which I received on DATE, there was a DOLLAR AMOUNT charge made at RETAILER NAME AND ADDRESS. This charge, made on DATE, posted to my account on DATE.

I am disputing the charge, which is circled on the enclosed copy of my statement.

I did not authorize any purchases at RETAILER to be charged to my account. ELABORATE ON YOUR REASON FOR DISPUTING THE CHARGE. FOR EXAMPLE, THE PRODUCT WAS NEVER ORDERED OR DELIVERED, THE PRODUCT OR SERVICE WAS NOT WHAT THE MERCHANT PROMISED OR THE AMOUNT CHARGED WAS INCORRECT. 

IF YOU DID BUY THE ITEM, BUT THE AMOUNT OF THE PURCHASE IS INCORRECT ON YOUR STATEMENT, NOTE HERE THAT YOU ALSO ARE ENCLOSING A COPY OF THE ORIGINAL CHARGE SLIP SHOWING THE CORRECT AMOUNT FOR WHICH YOU SHOULD BE BILLED. 

As required by the Federal Fair Credit Billing Act, please adjust my account in the above-referenced amount since REPEAT HERE WHY YOU ARE DISPUTING THE CHARGE. Please remove the DOLLAR AMOUNT charge from my bill and notify me in writing by sending me a new statement showing the correction.

If you have any questions or concerns, please contact me by mail at the address listed below or call me at TELEPHONE NUMBER. Thank you for your prompt attention to this matter.

Respectfully yours,
YOUR SIGNATURE
YOUR TYPED NAME
ADDRESS
CITY, STATE AND ZIP CODE

Enclosure: credit card statement AND ORIGINAL CHARGE SLIP IF APPLICABLE