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CARDHOLDER TRANSACTION DISPUTE FORM

Date : 26. February 2020
Card No: 4183 XXXX XXXX 7106
Cardholders Name: MAYA E BALDOVINO
Telephone No:
Transaction Details:

Date Amount (VND) Merchant

02/22/20 200.00 FACEBOOK.COM*ADS
02/22/20 200.00 FACEBK *ADS
02/22/20 200.00 FACEBK *ADS
02/22/20 200.00 FACEBOOK.COM*ADS

I have reviewed transaction/s above and hereby file a dispute for reason/s hereunder:

_____ I did not authorize or participate in the transaction(s) indicated above or authorize anyone to engage in the
transaction(s) and my card is in my possession at the time of purchase.

_____ These are lost card usages. My card was reported lost on __________.

_____ I have already paid the above transaction/s through:

Cash_____Check_____Another card_____Others
Attached is my receipt/proof of payment
_____ I engaged in one transaction, however, I was charged for more than one.

_____ The transactions amount on the sales slip was altered from Php ___________ to Php ___________.
Attached is my copy of the sales slip.

_____ I made the above transaction, however, I returned it on ___________________.

Attached is my proof of return/credit voucher issued by the establishment.

On _______________, I ordered the merchandise, however, I have not yet received it. Please credit my account.
Attached is my copy of the order form.

_____ Others, please specify.

______________________________________________________________________

SIGNATURE: ________________ Date _______________

*Please attach a copy of BDO Credit Card, passport and a valid ID*
Please sign and send back to fmu-cases-management-unit@bdo.com.ph
Fax No. 02-840-7329 loc 4305
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