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    0412 - Dispute Resolution Form - Fraud

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    Krishna Telgave
    The dispute resolution form is for a fraud dispute between an issuer and acquirer regarding a transaction. It provides transaction details including merchant name, reference number, transaction date and disputed amount. The issuer certifies that the cardholder claims no authorization for the transaction and that the card was closed, reported to fraud databases and listed on account stand-in files before the chargeback. The issuer representative signs that the facts provided are accurate to their knowledge.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    0412 - Dispute Resolution Form - Fraud

    Uploaded by

    Krishna Telgave
    768 views3 pages
    The dispute resolution form is for a fraud dispute between an issuer and acquirer regarding a transaction. It provides transaction details including merchant name, reference number, transaction date and disputed amount. The issuer certifies that the cardholder claims no authorization for the transaction and that the card was closed, reported to fraud databases and listed on account stand-in files before the chargeback. The issuer representative signs that the facts provided are accurate to their knowledge.

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    0412_Dispute Resolution Form_Fraud

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    The dispute resolution form is for a fraud dispute between an issuer and acquirer regarding a transaction. It provides transaction details including merchant name, reference number, transaction date and disputed amount. The issuer certifies that the cardholder claims no authorization for the transaction and that the card was closed, reported to fraud databases and listed on account stand-in files before the chargeback. The issuer representative signs that the facts provided are accurate to their knowledge.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    768 views3 pages

    0412 - Dispute Resolution Form - Fraud

    Uploaded by

    Krishna Telgave
    The dispute resolution form is for a fraud dispute between an issuer and acquirer regarding a transaction. It provides transaction details including merchant name, reference number, transaction date and disputed amount. The issuer certifies that the cardholder claims no authorization for the transaction and that the card was closed, reported to fraud databases and listed on account stand-in files before the chargeback. The issuer representative signs that the facts provided are accurate to their knowledge.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 3

    Dispute Resolution Form—

    Fraud

    Transaction Information:
    Acquirer’s Reference Data or Switch Serial Number:      
    Merchant Name:       Transaction or Settlement Date:      
    Number of Items:       Disputed Amount:      
    If multiple transactions are charged back, include the first transaction detail above and supply in the Additional Information section
    below or on separate pages the remaining unauthorized transactions disputed by the cardholder. Include for each transaction the
    merchant name, Acquirer Reference Data or Switch Serial Number and transaction amount.

    By completing this form, the issuer certifies its knowledge of the cardholder’s
    claim that neither he, she, nor anyone authorized by him or her engaged in the
    transaction(s) provided with this form.

    Card Status Information: Check all applicable boxes as required by the Chargeback Guide for this
    dispute.

    The card was closed and the issuer blocked the account on its host before the Yes No
    chargeback was processed:

    The transaction was reported to the Fraud and Loss Database (prior SAFE) before Yes No
    processing chargeback:

    The account was listed on the Account Management Service Stand-In Account File Yes No
    with a “capture card” response until card expiration:
    The cardholder was not in possession nor in control of the card issued to the account Yes No
    at the time of the transaction. The card used was lost, stolen or never received issue
    (NRI):

    The cardholder was in possession and control of the card issued to the account at Yes No
    the time of the transaction or the card used was counterfeit:

    Reason code 4837 when charging back CAT 2 transactions: Was the card lost, Yes No
    stolen, or NRI at the time of the transaction?
    Yes No
    Reason Code 4840: Was one legitimate transaction made at the same merchant
    location and at the time of the transaction the cardholder was in possession and
    control of all cards?

    Additional Information if needed

    412 Page 1 of 3 Revised: September 2018


    Dispute Resolution Form—
    Fraud

         

    “The issuer certifies that it complies with Mastercard Bylaws, Rules, policies and operating regulations
    and procedures of Mastercard (the “Standards”), written agreements and privacy laws and regulations
    applying to the protection of personal data. The issuer agrees that the personal data collected may be
    used according to Mastercard Standards and Mastercard’s Global Privacy Notice on
    http://www.mastercard.us/privacy/. I certify that the facts were obtained from my discussion with the
    cardholder or the company/government agency representative on behalf of the corporate/government
    card cardholder and that the facts are accurate to the best of my knowledge.”

    Customer Service/Chargeback Representative:       Date:      

    Issuer complete section below for Reason Code 4871- Chip Liability
    Shift—Lost/Stolen/Never Received Issue (NRI) Fraud Chargeback only:

    Card Issuer Region: Select One:

    Cardholder Verification Method (CVM) Hierarchy List Certification


    Number the priority sequence of CVM supported by the card from highest to lowest priority as 1, 2, 3, 4.
    Number 1 being the highest priority CVM on the card. If a CVM is not supported, leave that CVM option
    blank. See examples below:

         Online PIN Preferring


         Offline PIN
         Signature
         None (No CVM)

    412 Page 2 of 3 Revised: September 2018


    Dispute Resolution Form—
    Fraud

    Examples: Card’s CVM Priority or Hierarchy


    Example #1 – Card’s CVM priority or hierarchy is Online PIN, Offline PIN, Signature and then No CVM.  
    CVM hierarchy:   1 Online PIN Preferring  2 Offline PIN   3 Signature  4 None (No CVM)

    Example #2 – Card’s CVM priority or hierarchy is Online PIN, Signature and then No CVM. The card does not support Offline PIN.  
    CVM hierarchy: 1 Online PIN Preferring         Offline PIN   2 Signature  3 None (No CVM)

    Example #3 –Card’s CVM priority or hierarchy is Offline PIN, Signature and then No CVM. The card does not support Online PIN. 
    CVM hierarchy:      Online PIN Preferring   1 Offline PIN   2 Signature  3 None (No CVM)

    412 Page 3 of 3 Revised: September 2018

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