Visa Dispute InvestigationImportant Information about your PrivacyFirst Option Bank takes your privacy seriously. To see how we handle your personal information, please download and retain a copy of our Privacy Notification.Your DetailsMember Number *Full Name *Preferred Contact Number *Email AddressCard Number (first 4 digits) *Please choose44344133Card Number (last 4 digits) *Transaction DetailsDate of Transaction 1 *Merchant Name *Amount *AUDDate of Transaction 2Merchant NameAmountAUDDate of Transaction 3Merchant NameAmountAUDDo you have more disputed transactions?NoYesDate of Transaction 4Merchant NameAmountAUDDate of Transaction 5Merchant NameAmountAUDDate of Transaction 6Merchant NameAmountAUDDo you have more disputed transactions?NoYesIf so, please email them to info@firstoption.com.auType of DisputeI dispute the above mentioned transaction(s) for the following reason:Unauthorised Transaction - Transaction not authorised by Primary or Additional cardholder. The card was in my possession at the time of the transaction. Note: The card will be cancelled and a replacement card will be issued (subject to replacement card eligibility policy)Duplicate Billing - I was charged more than once for a single authorised transaction. I have not authorised the other transaction(s). My card was in my possession at the time of the transaction.Non-Receipt of Goods Refund/Credit not Processed - Credit transaction receipt issued but credit not processed to my account.Goods returned to Merchant but Refund not Processed. Cancelled Membership/SubscriptionPaid by other means - The transaction was charged to my account and was also paid by other means. Incorrect Amount Charged Services not Rendered - Services for the transaction(s) were not rendered due to the inability/unwillingness of the merchant. I have attempted to resolve this dispute with the merchant and/or merchant’s liquidator. Cancelled Accommodation - Accommodation was booked and cancelled within cancellation policy.Other - If your dispute does not fall into any of the above categories, please provide a detailed explanation of the circumstances surrounding your dispute below.Select one optionIf Other, please provide detailsDocumentation Required *Choose FileNo file chosenDelete uploaded filePlease upload supporting documentsHow did you use the card?Select "Over the phone or internet" if you were unaware of the transaction. *Over the phone or internetAt a physical locationPlease select one optionCard used over the phone or internetWas this transaction authorised by yourself?YesNoPlease be aware some merchants may appear under a different name on your statement.Have you (or someone you know) used your card for access to any mobile phone programs or gaming consoles?YesNoA subscription may be set up for add-ons to games, e.g. Apple, Xbox, MicrosoftNotes Please contact the merchant prior to lodging a dispute - we may not be able to lodge these on your behalf Any PayPal transactions need to be disputed through PayPal themselves as they have their own dispute resolution Please contact PayPal directly - we are NOT able to lodge these on your behalf Did you provide any extra verification details? YesNoe.g. Date of birth, pet's name or CVV (3 digits on back of card)Did you sign up for a Free Trial or similar offer?YesNoIf Yes, please attach any correspondence with the merchant alongside dates of the order and the cancellation.Have you attempted to contact the merchant to cancel your subscription?YesNoIf No, please contact the merchant prior to lodging a dispute.Upload DocumentationChoose FileNo file chosenDelete uploaded filee.g. Receipt, letter, invoice, notice, etc.Card used at a Physical LocationHas your card been Lost or Stolen (if not authorised by yourself)?YesNoIf either of these apply, First Option will stop your card and issue a new one (delivery of new card is 7-10 days).How did you pay?payWave (Tap & Pay)Insert Card with chip and entered PINSwipe magnetic strip and entered PINSignatureSelect one optionUpload DocumentsDocument 1 (if required)Choose FileNo file chosenDelete uploaded filee.g. Receipt, letter, invoice, notice, etc.Document 2 (if required)Choose FileNo file chosenDelete uploaded filee.g. Receipt, letter, invoice, notice, etc.Document 3 (if required)Choose FileNo file chosenDelete uploaded filee.g. Receipt, letter, invoice, notice, etc.Authorisation *I authorise First Option Bank to investigate the transaction(s) in dispute. Where applicable, I have provided the relevant supporting documentation requested above.DateSubmit
