IMPORTANT! 
PLEASE READ THEN DELETE THIS BOX

This is a template letter for guidance.  You need to add your details and where appropriate change the letter to suit your particular circumstances. 

Once you’ve made changes, always print it out and read through to check it makes sense to the recipient.

ACTION POINTS

[BLUE BRACKETS]: Put your specific info here, then delete the instructions (and change the text colour)

 [RED BRACKETS]: Just for info, after you’ve read delete

 [insert your name 
and address]

[insert date]
[insert name and 
address of your bank] 

Dear Sir or Madam,

Account number: [insert card number]

Ref: [select from Visa / Mastercard] Chargeback

[Use this section for all letters]
I am writing to request that under your Chargeback rules you reimburse me the value of [enter amount] as [select from full payment for / partial payment towards] a [enter item purchased] I paid for with my [select from debit / credit]  to [enter company name] on [enter date].
 
[Use this section if the company has gone into administration or delete]
My claim is made on the grounds that the company has gone into administration and I will not be able to receive the item or my money back.  

[Use this section if you have a faulty good or delete]
My claim is made on the grounds that the item purchased was faulty in the following ways ([enter brief details on what was wrong with your item]) and I have been unable to resolve my complaint with the supplier. 

[Use this section if you have been the victim of fraud or delete]
My claim is made on the grounds that I did not authorise or attempt to carry out this transaction and have been the victim of fraud. 

[Use this section if there has been a clerical error or delete]
My claim is made on the grounds that there has been a clerical error as [select from I have been charged multiple times for one item / I have been billed for the wrong amount].

[Use this section for all letters]
I look forward to a full and prompt response to this letter within 14 days.

Yours faithfully,

[insert your signature]

[insert your name (printed)] 

[Include any evidence you have to prove your case to help your claim]