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To: Cardholder Dispute & Chargeback Section, HSBC Card Services, 8/F Tower 2 & 3 HSBC Centre, 1 Sham M o n g R o a d , K i n
:12 & 38
Facsimile(852) 2269 3080
Your reference number
.(Please fill in your card
Trans date
Disputed amount
Trans amount
Merchant name
number
I refer to the above transaction(s) and advise that (Please select the dhpuie reason listed below.)
5.)
I have neither made nor authorised the above transaction(s).
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/()
The merchant made an addition or transposition error. I enclose the transaction receipt copy i n support.
to
without m y consent
I have received a credit transaction receipt(s) from the merchant. However, no credit was posted to my card account. A
copy of the credit slip is enclosed.
The merchandise was to be shipped. I received i t and returned i t back to the merchant. The merchant did not properly
disclose a l i m i t e d return policy at the time o f transaction and no credit was received. A copy o f the relevant document/s is
enclosed
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/()/()
I have neither made nor authorised the transactions and w i l l not accept any subsequent transactions posted after the above
one.
I have neither made nor authorised the above transaction (transaction receipt no.
). I was still
in possession and control o f all valid cards at the time o f the transaction. 1 only authorised the transaction amount o f
on
(transaction receipt no.
)
7fc.(
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I did engage i n the above transactioti(s) but I did not receive the requested cash I
for the amount o f
/(
I or my authorised person did not receive the service / merchandise from the merchant. A copy of the order f o r m is
enclosed.
/
The merchandise / service received is not as described as the one I ordered/purchased from the merchant.
(Please specify how the merchandise is not as described and provide relevant proof t o show the
difference / cieffectiveness)
/()/''
(
The order I made was i n
merchant is i n
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)"1
3().
Signature
Cardholder's name W ^ J\ M . ^ .
Date
Contact number
Note: Please sign and return this form to the above facsimile number within fourteen days. Should you have any questions, please
feel free to contact us on (852) 2288 3194.