Fillable Travel Money Disputed Transactions Request for Investigation (Commonwealth Bank of Australia)

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Travel Money Disputed Transactions Request for Investigation (Commonwealth Bank of Australia)

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Travel Money Disputed Transactions
Request for Investigation
Important
By completing this form you are accepting that your Travel Money Card(s) will be blocked permanently where the disputed
transaction(s) took place. If your secondary card is not impacted by the dispute(s), you may use this card to access your funds.
Ifthis is not the case, you should request a new/replacement set of Travel Money Card(s) before you lodge this dispute form or
use another form of payment.
Commonwealth Bank of Australia
ABN 48 123 123 124
Australian credit licence 234945
Page 1 of 3004-108 310818
✗
Cardholders signature
Section 1 – Cardholders details
Section 2 – Reason for investigation
Travel Money Card number - Primary Travel Money Card number - Backup
Last name
First nameInitials
Date
I request the Bank to investigate this claim and declare that the details are true and correct to the best of my knowledge.
• Please keep a copy of this completed form and original documentation.
• The signed form must be sent by mail to the address indicated or emailed to arbitration@cba.com.au.
• If acknowledgement of your request is not received within 10 business days, please call Travel Money on 1300 660 700.
To: 2067 Operations Processing Centre, Reconciliations and Disputes
PO Box 492, Lidcombe NSW 1825
Facsimile number: (02) 8737 3623
Title Mr
Mrs Miss
Ms
Other
Date
I did not authorise the transaction(s) that appear on my card
I only authorised one of the transactions that appear on my card (i.e. there is a duplication)
I did engage in the transaction but did not receive the goods/services ordered (mail/telephone/internet). I have attempted to
contact the merchant without success
The attached credit voucher has not been credited to my card
I used another method of payment for this transaction, not the above Travel Money card and I enclose my proof of payment
Other (e.g. amount(s) incorrectly processed)
Details of disputed transactions as they appear in the transaction listing available at www.commbank.com.au/travelmoney
Date and Time Amount Merchant description/details
$
$
$
$
$
Home address
State Postcode
Home
Business Mobile
Contact telephone numbers (include STD area code)
Customer email
DD/MM/YYYY
DD/MM/YYYY
( )
( )
Section 3 – Details
Please attach copies of vouchers or transaction receipts and any other documentation that may assist us in our investigation.
Please give details about the transaction(s) requiring investigation together with the name and address of any witnesses. Specify
the exact nature of the dispute and if any contact has been made with the merchant involved and the outcome.
Have you ever given your card to another person (e.g. partner, child, friend) to use?
Yes No
Have you given anyone your PIN at any time to make a transaction or ATM withdrawal on your behalf?
Yes No
Do you keep a record of the PIN(s)?
Yes No
Is/Are the PIN(s) disguised?
Yes No
Have you ever selected your own PIN(s) at an ATM or by calling the Travel Money IVR?
Yes No
When you received the PIN(s) advice from the Bank, did you destroy the original?
Yes No
Please provide name and address details
Please provide details
How and where is the PIN recorded (do not provide PIN)?
Where is/are the Card(s) kept on a daily basis?
If no record is kept, how do you ensure that you remember your PIN(s)?
Was/were the cards signed?
Yes No
Please provide details of the last valid transaction
Please tick (✔) appropriate box
Have you ever provided your PIN(s) and card number(s) in response to an email?
Yes No
Please provide details
Do you suspect someone?
Yes No
Please provide details of suspect, (full name, contact address and phone numbers)
Please provide suspect description/appearance
Please provide suspect relationship to yourself, date of birth and approximate age
Details of aliases
Page 2 of 3004-108 310818
Section 3 – Details (continued)
Where was the card(s) lost or stolen?
Please provide details of the loss/theft
Please provide date and time the loss/theft was reported to the Bank
Has the card ever been lost or stolen?
Yes No
Date and time of loss/theft
Lost/Stolen details:
Police station
Police officer name and contact number
Are there any other factors which you believe should be taken into account when the Bank considers whether you are liable or
partially liable for disputed transactions? Include such circumstances as delay in notification, how the loss occurred or any other
details you consider relevant.
Have you reported the stolen card to the police?
Yes No
Police details:
Section 4 – Advice to Customer
The following information is provided for your guidance.
1. Ensure you have requested a stop on your card(s) if your card(s) or PIN(s) are stolen or your PIN has become known to another party.
2. If you require replacement cards, notify Travel Money on 1300 660 700.
3. Your dispute will be settled in accordance with the terms and conditions outlined in the Travel Money Product Disclosure
Statement (PDS).
4. Where we are required to do so, we normally re-credit your card within 10 days, although there may be a delay while our
investigations are completed. Investigations usually take a maximum of 45 days from receipt of all information. However in
exceptional circumstances we may advise you in writing if this time limit is to be exceeded.
5. This acknowledgement should be retained until the dispute has been resolved. Please contact Travel Money on 1300 660 700
should you have any queries relating to this dispute.
Page 3 of 3004-108 310818
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Travel Money Disputed Transactions Request for Investigation (Commonwealth Bank of Australia)

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Completed 29 July 2020

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