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SunTrust Visa Business Card Dispute Form
Name: ________________________________ Account Number: _____________________________ Posting Date ______________ ______________ ______________ Merchant Name ____________________________ ____________________________ ____________________________ Dollar Amount ____________ ____________ ____________
Please check the appropriate reason(s):
I no longer wish to dispute this transaction(s). To the best of my knowledge, I did not participate in or authorize the above referenced. Although I ordered merchandise from the above merchant, to this date I have not received the merchandise. I have contacted the merchant and requested a credit adjustment that I did not receive, or that was not satisfactory. The expected delivery date was ____________________. Although I did not engage in the above transaction, I dispute the entire charge or a portion in the amount of $__________________. I have contacted the merchant and requested a credit adjustment. I either did not receive the credit or it was unsatisfactory. I am disputing the charge because: (Please provide a detailed letter and include information regarding your efforts to resolve the dispute with the merchant) I have returned the merchandise to the merchant on _____________ (PROOF OF RETURN RECEIPT REQUIRED) I cancelled the reservations on _____________________ and cancellation number (if applicable) _____________________ I only made ______ charge(s), but was billed ______ times for the same charge from this merchant. I have my cards in possession. Enclosed is a copy of the sales slip. Yes No I have cancelled my enrollment with the merchant named above. I am requesting a credit be given for this charge. The date of cancellation was __________________. Enclosed is a copy of the cancellation letter. Enclosed is a copy of the credit slip that was not applied to my account. I received the merchandise or services; however, the merchant was paid by another method (i.e. cash, check, another credit card) (PROOF OF PAYMENT REQUIRED) The amount of the sales slip was increased from $_________________ to $________________. Enclose a copy of the sales slip prior to alteration. If needed, please add another sheet for additional comments. _________________________________________ Cardholder Signature Send this form to: SunTrust BankCard, N.A. Attn: Corporate Disputes P.O. Box 4910 Orlando, FL 32802-4910 _____________________ Date __________________________ Daytime Phone
Dispute Inquiry: Toll Free: 1-877-864-0197 Fax: 407-762-5405 Customer Service: 1-800-836-8562