November 17, 2023

PO Box 790140
St. Louis, MO 63179-0140

ACTION REQUIRED

Jitesh Mhatre
Cardmember since 2021
JITESH MHATRE
Card ending in 3362
246 MOWRY AVE Case ID: D-469066161123
FREMONT CA 94536-4105

Please provide the information requested

below

Hi, Jitesh. We opened your dispute for the $290.97 transaction with LAXMI CROCKERY
STORE THANE IN, and need some more information to help us with our investigation.

We're missing some important information

If you haven't already, please first contact the merchant, then complete the following
information and send it back to us. Along with this form, please also send any or all of
the following documentation you have to support your statements: cash payment receipt,
canceled check (front and back), card statement reflecting the authorized charge (a
sales slip is not sufficient), or proof of payment to the merchant by a travel agency or
domestic affiliate.

This merchant charged my account for merchandise; however, I paid them $_________
by _________________________.
Please specify the manner of payment, such as cash or personal check, etc.

The merchant's response to my request for credit was

____________________________________________________________________.

I attempted to contact the merchant but couldn't reach them because

______________________________________________________________________
___________________________________________________________________.

Signature _______________________________

0.L0970092003.I2023111770055090.520.I.SD.CI.0001.PHO NU SER .EP.D-469066161123-ADVPBO M

Jitesh Mhatre
Page 2 of 3 Case ID : D-469066161123
Card ending in 3362

ACTION REQUIRED

Date ____________

If you've already sent us this information - there's nothing you need to do. If you haven't,
just complete this form and email it to us at billingdisputes@citi.com. You can also fax it
to 1-844-357-8355, or mail it to us at:

PO Box 790140
St. Louis, MO 63179-0140

If you send us this information by email, please don't attach zip files - they're not
compatible with our system. Be sure to include this ID in the subject line of your email:
D-469066161123.

If this transaction is correct and you don't want to continue this dispute, cancel it in Citi®
Online, the Citi Mobile® App or by calling us at 1-855-378-6467. For TTY: We accept 711
or other Relay Service.

We gave you a credit

While we review your dispute, we've issued a conditional credit to your account.

If we don’t hear from you by November 27, 2023 we'll investigate with the information we
have available, and the conditional credit may be reversed.

Here are your dispute details

We included the below transaction details for the dispute(s) on card ending in 3362 for
your reference.
Date November 8, 2023
Amount $290.97
Merchant/Description LAXMI CROCKERY STORE THANE IN
Jitesh Mhatre
Page 3 of 3 Case ID : D-469066161123
Card ending in 3362

ACTION REQUIRED

We'll always keep you updated during the dispute process. You can track your dispute
status anytime in the Citi Mobile® App or Citi® Online. You can also reach us at
1-855-378-6467. For TTY: We accept 711 or other Relay Service.

Citi is at your side before, during and after every purchase.

Your Citi Team

Protecting your personal information is important to us. If you are emailing documentation to us, do not include any personal

information in the documentation or in your email. This would include, but is not limited to, your account number, home address,

Social Security number, etc.

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