Product: Credit card or prepaid card

Claim number : XXXX The following withdraws were taken from my account. I am asking that Community Bank review these transactions and replace the funds. 

XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX Once again, I am requesting an itemized list of the transactions that were denied. Please send the information to the following address : XX/XX/XXXX Claim number : XXXX Once again, I am requesting an itemized list of the transactions that were denied and the details behind each decision. 

To date, after numerous requests I have not received anything in writing. 

Customer Dispute Form _______________________________________________________________________________________________________ Cardholder Name* ( First and Last Name ) XXXX XXXX XXXX XX/XX/XXXX XXXX : _______________ ____________________ Card Number* ( last 4-digits ) XXXX XXXX XXXX XXXX NJ XXXX XXXX ________________________________ City* State* Zip* Address* Claim # * : ______________________________ Lost/Stolen : Is the Card in your possession? Yes No Date Lost or Stolen : _______________ Date loss or theft was reported to XXXX XXXX XXXX  _______________ Have you ever authorized anyone else to use your Card? Yes No If yes, who? ____________________ Please list the transactions below that you are disputing and complete page 2. If you need additional space, you can include detail on page 3 with all transactions being disputed. 
XXXX If you do not have a claim number, please contact Customer Service. 
If no, was the Card : Lost? Stolen?

Cardholder Discovery Date : _______________ XX/XX/XXXX Post Date Amount ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ Merchant Description ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ Transaction Date ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ Please see a detail account of the transactions and my response to these transactions below. 
______________________ ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ Please return all pages of this document and any additional supporting documentation via one of the following methods : Print and Mail DISPUTES XXXX XXXX XXXX XXXX, XXXX XXXX Print and Fax Fax : XXXX Email XXXX ( Email documents in TIF or PDF only ) *Required Please complete the following information to the best of your ability to assist us in working your claim. You may also consider 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. 
DUPLICATE PROCESSING Original transaction authorized _________________ for $ XXXX MERCHANDISE NOT RECEIVED Product ordered _______________________________ Shipped date _______________ Attempt to resolve? Yes No Delivered to wrong address? Yes No Merchant contact date _______________ MERCHANDISE RETURNED Shipped/Returned date _______________ Attempt to resolve : Yes No Include return/shipping receipt or relevant merchant correspondence. CANCELLED TRANSACTION Cancelled transaction date _______________ Cancellation number : __________________________ UNAUTHORIZED TRANSACTION Neither I, nor anyone, authorized by me engaged in the transaction with the above listed merchant. 
OTHER PAID BY OTHER MEANS Original form of payment : Cash Card Please provide copy of receipt or proof of payment. 
SERVICES NOT RENDERED Service expected _______________________________ Supposed received date _______________ Attempt to resolve? Yes No Merchant contact date _______________ CREDIT NOT RECEIVED Merchant contact date _______________ Partial credit : Yes No If yes, $ _____________ Include return/shipping receipt or relevant merchant correspondence. QUALITY PROBLEM Describe in detail on page XXXX Attempt to resolve : Yes No Merchant contact date _______________ ATM NON-DISPENSE Amount received from the ATM $ ________________ Describe in detail below or attach a detailed explanation. Include all documentation supporting your dispute. 
Claim # XXXX I don't know how your company determine that the following withdraws were associated with me. If you look at the transactions that are legitimate the following transactions are not associated with anything I authorized. These transactions were initiated by scammers. Please provide me with detailed information and any evidence your company has that determined I am associated with the following withdraws : XX/XX/XXXX XXXX ( {$40.00} ) {$41.00} XXXX Can you please tell me where this transaction originated? I was sleeping at the time. 
X CARDHOLDER SIGNATURE __________________________ TELEPHONE NUMBER ( S ) _____________ DATE ADDITIONAL DETAILS XX/XX/XXXX XXXX ( {$85.00} ) {$380.00} XXXX I was sleeping. Who is XXXX and where did this originate? Are cameras at that location? 
XX/XX/XXXX XXXX ( {$150.00} ) {$220.00} XXXX XXXX XXXXXXXXXXXX XXXX  XX/XX/XXXX XXXX XXXX XXXX XXXX XXXX XXXXAarecameras Are cameras available at the site where the money was stolen? I did not authorize these transactions. XXXX? who is this? 
XX/XX/XXXX XXXX ( {$100.00} ) {$240.00} XXXX XXXX XXXXXXXX XXXX XXXX was at it again? I would appreciate any information you can provide. 
XX/XX/XXXX XXXX ( {$330.00} ) {$380.00} XXXX? There must be cameras at this site. 
XXXXXXXX XXXX XXXX XXXX XXXXXXXX XX/XX/XXXX XXXX ( {$440.00} ) {$290.00} XXXX XXXX XXXXXXXX XXXX XXXX This must be the same person ( thief ). What does XXXX mean? Where was the money sent. 
XX/XX/XXXX XXXX ( {$170.00} ) {$72.00} XXXX XXXXXXXX XXXX XXXX XXXX  Once again, the same person. Please do an thorough investigation. If this is XXXX XXXX  I was sleeping. 
XX/XX/XXXX XXXX ( {$50.00} ) {$240.00} XXXX  XXXX XXXX  XXXX XXXX XXXX. XXXX? XXXX? Please let me know how you determined this withdraw is associated with me? 
XX/XX/XXXX XXXX ( {$49.00} ) $ XXXX What is XXXX? I don't know what/ who this is or why XXXX was withdrawn. 
XX/XX/XXXX XXXX ( {$800.00} ) {$55.00} XXXX XXXXClaim number : XXXX As noted in my XX/XX/XXXX email, I am requesting an itemized list of the transactions that were denied and the details behind each decision. 
To date, after numerous requests I have not received anything in writing. 


XX/XX/XXXX Claim number : XXXX Please refer to my XX/XX/XXXX request for an itemized list of the transactions that were denied and the details behind each decision. 

To date, after numerous requests I have not received anything in writing. Please include an explanation for the problem regarding the delay. 



XX/XX/XXXX Claim number : XXXX Please refer to my XX/XX/XXXX request for an itemized list of the transactions that were denied and the details behind each decision. 

To date, after numerous requests I have not received a response in writing. Please include an explanation for the problem regarding the delay. 

XX/XX/XXXX. Claim number : XXXX Please refer to my multiple requests for an itemized list of the transactions that were denied and the details behind each decision. I provided you with detailed information in XX/XX/XXXX and to date, I am waiting for your reply. 

To date, after numerous requests I have not received a response in writing. Please include an explanation for the problem regarding the delay. 


The initial denial was confirmed within 24 hours after it was initiated. It appears that my complaint was not even reviewed. 

These requests do not include telephone conversations with customer service personal. I have asked to speak to someone in the " department '' that reviews these complaints ; however, I was informed that is impossible. I went to the Community Bank  in XXXXXXXX XXXX  and was told to call customer service. 

As noted above, I have not receive an explanation as requested. 

Please help me resolve this complaint. I have already paid state taxes and will be paying federal taxes on this money that I never received. 

Respectfully, XXXX XXXX