This is the general questionnaire structure for the response to `/claim/intake/retrieveQuestionnaire` when the dispute is for a Visa and it is not fraud. I participated in this transaction, but there is a problem. _Which of the following best describes the reason for your dispute?_

I have not received the merchandise or services that I purchased.

- _[required]_ Are you disputing the full amount of the transaction? [`Yes/No`] - **No** — - What amount are you disputing? [`Text`] - Why is the dispute different than the posted transaction amount? [`Text`] - **Yes** - _[required]_ Is the purchase a third-party gift card without an expiration date, where the merchandise or services were not provided by the third party due to insolvency or bankruptcy? [`Yes/No`] - **No** - **Yes** - _[required]_ What was not received? [`BulletList`]

― Merchandise

- _[required]_ Did the merchant cancel the merchandise? [`Yes/No`] - **No** - **Yes** — - Date merchant cancelled merchandise [`Date`] - Is the merchant in bankruptcy or liquidation? [`Yes/No`] - **No** - **Yes** - _[required]_ Are you still expecting a delivery for the merchandise? [`Yes/No`] - **No** - **Yes** — - Why are you initiating a dispute prior to the expected delivery date? [`Text`] - What is the last expected receipt date for the merchandise? [`Date`] - _[required]_ What was the expected receipt time for the merchandise? [`Date`] - _[required]_ Was the merchandise delivered to the incorrect location? [`Yes/No`] - **No** - **Yes** — Please provide the address of the agreed upon location. [`Text`] - _[required]_ Was the merchandise delivered late? [`Yes/No`] - **No** — Did you attempt to return the merchandise? [`Yes/No`] - **No** - **Yes** — When did you attempt to return it? [`Date`] - **Yes** — Please provide details of late delivery. [`Text`] - _[required]_ Did you return the merchandise? [`Yes/No`] - **No** - **Yes** — - When did you return the merchandise? [`Date`] - Do you know when the merchant received the merchandise? [`Yes/No`] - **No** - **Yes** — - When did the merchant receive the merchandise? [`Date`] - What return method did you use? [`BulletList`] - **Face to Face** - **FedEx** — What was the tracking number? [`Text`] - **DHL** — What was the tracking number? [`Text`] - **UPS** — What was the tracking number? [`Text`] - **Postal Service** — What was the tracking number? [`Text`] - **Other** — Please explain: [`Text`] - _[required]_ Did you cancel prior to the expected receipt date? [`Yes/No`] - **No** - **Yes** — When did you cancel? [`Date`] - _[required]_ Did you attempt to resolve with the merchant? [`Yes/No`] - **No** — Are there local laws or regulations prohibiting you from resolving with the merchant? [`Yes/No`] - **No** - **Yes** — Please explain. [`Text`] - **Yes** - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

― Service

- _[required]_ Did merchant cancel services? [`Yes/No`] - **No** - **Yes** — Date the merchant cancelled services [`Date`] - _[required]_ Is the merchant in bankruptcy or liquidation? [`Yes/No`] - **No** - **Yes** - _[required]_ Was non-fiat currency (e.g. cryptocurrency) or non-fungible token(s) not successfully delivered to the destination wallet address supplied by the Cardholder at the time of the Transaction? [`Yes/No`] - **No** - **Yes** — Note: Please provide evidence that the non-fiat currency or non-fungible token(s) was not successfully delivered to the destination wallet address at the time of the Transaction. [`Text`] - _[required]_ Are you still expecting a service delivery? [`Yes/No`] - **No** - **Yes** — - Why are you initiating a dispute prior to the expected delivery date? [`Text`] - What is the last expected receipt date for the service? [`Date`] - What was the expected receipt time for the service? [`Date`] - Did you cancel the service prior to the expected receipt date? [`Yes/No`] - **No** - **Yes** — - When did you cancel? [`Date`] - Why did you cancel? [`Text`] - _[required]_ Did you attempt to resolve with the merchant? [`Yes/No`] - **No** — Are there local laws or regulations prohibiting you from resolving with the merchant? [`Yes/No`] - **No** - **Yes** — Please explain. [`Text`] - **Yes** - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

I cancelled or returned the merchandise or service and have not received the expected credit.

- _[required]_ Are you disputing the full amount of the transaction? [`Yes/No`] - **No** — - What amount are you disputing? [`Text`] - Why is the dispute different than the posted transaction amount? [`Text`] - **Yes** - _[required]_ Were you provided a credit voucher, voided transaction receipt or refund acknowledgement? [`Yes/No`] - **No** — When did you cancel the service or return the merchandise? [`Date`] - **Yes** - _[required]_ What was purchased? [`BulletList`]

― Merchandise

- _[required]_ Please provide details about the merchandise. [`Text`] - _[required]_ When did you receive or expect to receive the merchandise? [`Date`] - _[required]_ Did you receive the merchandise? [`Yes/No`] - **No** - **Yes** - Did you return the merchandise? [`Yes/No`] - **No** — Did you attempt to return the merchandise? [`Yes/No`] - **No** - **Yes** — - When did you attempt to return it? [`Date`] - Please provide a detailed description of how you attempted to return the merchandise. [`Text`] - Where is the merchandise at this time? [`Text`] - Please select one of the options below which best represents the return attempt. [`BulletList`] - The merchant refused to provide return authorization. - The merchant refused to accept the returned merchandise. - The merchant informed not to return the merchandise. - The merchant no longer exists or is not responding. - The merchant did not provide clear instruction on how to return. - **Yes** — - When did you return the merchandise? [`Date`] - Do you know when the merchant received the merchandise? [`Yes/No`] - **No** - **Yes** — - When did the merchant receive the merchandise? [`Date`] - What return method did you use? [`BulletList`] - **Face to Face** - **FedEx** — What was the tracking number? [`Text`] - **DHL** — What was the tracking number? [`Text`] - **UPS** — What was the tracking number? [`Text`] - **Postal Service** — What was the tracking number? [`Text`] - **Other** — Please explain: [`Text`] - _[required]_ Did you cancel the order? [`Yes/No`] - **No** - **Yes** — - When did you cancel? - Did you cancel prior to the shipment date? [`Yes/No`] - **No** - **Yes** - Why did you cancel? [`Text`] - Was a cancellation policy provided? [`Yes/No`] - **No** - **Yes** - _[required]_ Did you attempt to resolve with the merchant? [`Yes/No`] - **No** — Are there local laws or regulations prohibiting you from resolving with the merchant? [`Yes/No`] - **No** - **Yes** — Please explain. [`Text`] - **Yes** - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

― Service

- _[required]_ What type of service was it? [`BulletList`] - **Timeshare** — What was the date of the timeshare, or when was the contract and/or related documents received? [`Date`] - **Guaranteed Reservation** — When was the service provided or expected? [`Date`] - **Other** — Please explain: [`Text`] - _[required]_ Did you cancel the service? [`Yes/No`] - **No** - **Yes** — - When did you cancel or attempt to cancel? [`Date`] - Why did you cancel? [`Text`] - Was a cancellation policy provided? [`Yes/No`] - **No** - **Yes** - _[required]_ Did you attempt to resolve with the merchant? [`Yes/No`] - **No** — Are there local laws or regulations prohibiting you from resolving with the merchant? [`Yes/No`] - **No** - **Yes** — Please explain. [`Text`] - **Yes** - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

Credit not processed. I cancelled or returned the merchandise or service and have not received the expected credit.

- _[required]_ Are you disputing the full amount of the transaction? [`Yes/No`] - **No** — - What amount are you disputing? [`Text`] - Why is the dispute different than the posted transaction amount? [`Text`] - **Yes** - _[required]_ Were you provided a credit voucher, voided transaction receipt or refund acknowledgement? [`Yes/No`] - **No** — Is the credit voucher, transaction receipt, or refund acknowledgement dated? [`Yes/No`] - **No** — When did you cancel the service or return the merchandise? [`Date`] - **Yes** — What is the date on the credit voucher, transaction receipt, or refund acknowledgement [`Date`] - **Yes** - _[required]_ What was purchased? [`BulletList`]

― Merchandise

- _[required]_ Please provide details about the merchandise. [`Text`] - _[required]_ When did you receive or expect to receive the merchandise? [`Date`] - _[required]_ Did you receive the merchandise? [`Yes/No`] - **No** - **Yes** - Did you return the merchandise? [`Yes/No`] - **No** — Did you attempt to return the merchandise? [`Yes/No`] - **No** - **Yes** — - When did you attempt to return it? [`Date`] - Please provide a detailed description of how you attempted to return the merchandise. [`Text`] - Where is the merchandise at this time? [`Text`] - Please select one of the options below which best represents the return attempt. [`BulletList`] - The merchant refused to provide return authorization. - The merchant refused to accept the returned merchandise. - The merchant informed not to return the merchandise. - The merchant no longer exists or is not responding. - The merchant did not provide clear instruction on how to return. - **Yes** — - When did you return the merchandise? [`Date`] - Do you know when the merchant received the merchandise? [`Yes/No`] - **No** - **Yes** — - When did the merchant receive the merchandise? [`Date`] - What return method did you use? [`BulletList`] - **Face to Face** - **FedEx** — What was the tracking number? [`Text`] - **DHL** — What was the tracking number? [`Text`] - **UPS** — What was the tracking number? [`Text`] - **Postal Service** — What was the tracking number? [`Text`] - **Other** — Please explain: [`Text`] - _[required]_ Did you cancel the order? [`Yes/No`] - **No** - **Yes** — - When did you cancel? [`Date`] - Did you cancel prior to the shipment date? [`Yes/No`] - No - Yes - Why did you cancel? [`Text`] - Was a cancellation policy provided? [`Yes/No`] - **No** - **Yes** - _[required]_ Did you attempt to resolve with the merchant? [`Yes/No`] - **No** — Are there local laws or regulations prohibiting you from resolving with the merchant? [`Yes/No`] - **No** - **Yes** — Please explain. [`Text`] - **Yes** - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

― Service

***

I have an issue with a recurring transaction on my account.

- _[required]_ When did you cancel the recurring transaction? [`Date`] - _[required]_ Why did you cancel? [`Text`] - _[required]_ How did you contact the merchant to cancel? [`BulletList`] - **Call Center/SMS/Text Message** — Which did you use to contact the merchant? [`BulletList`] - **Call Center** - **SMS/Text Message** - **Both** - Please provide the number you contacted. [`Text`] - **Email** — Please provide the email address you contacted. [`Text`] - **Mail** — Please provide the mailing address you contacted. [`Text`] - **In-Person** — Please provide the physical address you contacted. [`Text`] - **Application Name** — Please provide the Application Name you used to cancel. [`Text`] - _[required]_ Was another form of payment provided for this transaction? [`Yes/No`] - **No** - **Yes** — Please describe the other form of payment. [`Text`] - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

I am dissatisfied with the merchandise or a service I received.

_What is the issue with the merchandise or service?_

The merchandise is counterfeit.

***

The merchandise is damaged or defective.

- _[required]_ Are you disputing the full amount of the transaction? [`Yes/No`] - **No** — - What amount are you disputing? [`Text`] - Why is the dispute different than the posted transaction amount? [`Text`] - **Yes** - _[required]_ Please provide a description of what was ordered. [`Text`] - _[required]_ When did you receive the merchandise/service? [`Date`] - _[required]_ Did you return the merchandise? [`Yes/No`] - **No** — Did you attempt to return the merchandise? [`Yes/No`] - **No** - **Yes** — - When did you attempt to return it? [`Date`] - Please provide a detailed description of how you attempted to return the merchandise. [`Text`] - Where is the merchandise at this time? [`Text`] - Please select one of the options below which best represents the return attempt. [`BulletList`] - The merchant refused to provide return authorization. - The merchant refused to accept the returned merchandise. - The merchant informed not to return the merchandise. - The merchant no longer exists or is not responding. - The merchant did not provide clear instruction on how to return. - **Yes** — - When did you return the merchandise? [`Date`] - Do you know when the merchant received the merchandise? [`Yes/No`] - **No** - **Yes** — - When did the merchant receive the merchandise? [`Date`] - What return method did you use? [`BulletList`] - **Face to Face** - **FedEx** — What was the tracking number? [`Text`] - **DHL** — What was the tracking number? [`Text`] - **UPS** — What was the tracking number? [`Text`] - **Postal Service** — What was the tracking number? [`Text`] - **Other** — Please explain: [`Text`] - _[required]_ Did you attempt to resolve with the merchant? [`Yes/No`] - **No** — Are there local laws or regulations prohibiting you from resolving with the merchant? [`Yes/No`] - **No** - **Yes** — Please explain. [`Text`] - **Yes** - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

The merchandise or service has a quality issue.

― Merchandise

- _[required]_ Is dispute related to the quality of food received from eating places or restaurants? [`Yes/No`] - **No** - **Yes** - _[required]_ Please provide a description of the merchandise and the quality issue. [`Text`] - _[required]_ When did you receive the merchandise/service? [`Date`] - _[required]_ Did you return the merchandise? [`Yes/No`] - **No** — Did you attempt to return the merchandise? [`Yes/No`] - **No** - **Yes** — - When did you attempt to return it? [`Date`] - Please provide a detailed description of how you attempted to return the merchandise. [`Text`] - Where is the merchandise at this time? [`Text`] - Please select one of the options below which best represents the return attempt. [`BulletList`] - The merchant refused to provide return authorization. - The merchant refused to accept the returned merchandise. - The merchant informed not to return the merchandise. - The merchant no longer exists or is not responding. - The merchant did not provide clear instruction on how to return. - **Yes** — - When did you return the merchandise? [`Date`] - Do you know when the merchant received the merchandise? [`Yes/No`] - **No** - **Yes** — - When did the merchant receive the merchandise? [`Date`] - What return method did you use? [`BulletList`] - **Face to Face** - **FedEx** — What was the tracking number? [`Text`] - **DHL** — What was the tracking number? [`Text`] - **UPS** — What was the tracking number? [`Text`] - **Postal Service **— What was the tracking number? [`Text`] - **Other** — Please explain: [`Text`] - _[required]_ Did you attempt to resolve with the merchant? [`Yes/No`] - **No** — Are there local laws or regulations prohibiting you from resolving with the merchant? [`Yes/No`] - **No** - **Yes** — Please explain. [`Text`] - **Yes** - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

― Service

- _[required]_ Was non-fiat currency or purchase of non-fungible token(s) (NFT), the non-fiat currency or non-fungible token received by the cardholder did not match the description provided at the time of the transaction? [`Yes/No`] - **No** - **Yes** - _[required]_ Is dispute related to the quality of food received from eating places or restaurants? [`Yes/No`] - **No** - **Yes** - _[required]_ Please provide a description of the service and the quality issue. [`Text`] - _[required]_ When did you receive the service? [`Date`] - _[required]_ Did you have to pay for work to be redone? [`Yes/No`] - **No** - **Yes** - _[required]_ Did you cancel the service? [`Yes/No`] - **No** - **Yes** — - When did you cancel? [`Date`] - Why did you cancel? [`Text`] - Did the merchant accept the cancellation? [`Yes/No`] - **No** - **Yes** - _[required]_ Did you attempt to resolve with the merchant? [`Yes/No`] - **No** — Are there local laws or regulations prohibiting you from resolving with the merchant? [`Yes/No`] - **No** - **Yes** — Please explain. [`Text`] - **Yes** - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

The merchandise or service is not as described.

― Merchandise

- _[required]_ Is dispute related to the quality of food received from eating places or restaurants? [`Yes/No`] - **No** - **Yes** - _[required]_ Please provide details of what was ordered and not as described. [`Text`] - _[required]_ When did you receive the merchandise/service? [`Date`] - _[required]_ Did you return the merchandise? [`Yes/No`] - **No** — Did you attempt to return the merchandise? [`Yes/No`] - **No** - **Yes** — - When did you attempt to return it? [`Date`] - Please provide a detailed description of how you attempted to return the merchandise. [`Text`] - Where is the merchandise at this time? [`Text`] - Please select one of the options below which best represents the return attempt. [`BulletList`] - The merchant refused to provide return authorization. - The merchant refused to accept the returned merchandise. - The merchant informed not to return the merchandise. - The merchant no longer exists or is not responding. - The merchant did not provide clear instruction on how to return. - **Yes** — - When did you return the merchandise? [`Date`] - Do you know when the merchant received the merchandise? [`Yes/No`] - **No** - **Yes** — - When did the merchant receive the merchandise? [`Date`] - What return method did you use? - **Face to Face** - **FedEx** — What was the tracking number? [`Text`] - **DHL** — What was the tracking number? [`Text`] - **UPS** — What was the tracking number? [`Text`] - **Postal Service** — What was the tracking number? [`Text`] - **Other** — Please explain: [`Text`] - _[required]_ Did you attempt to resolve with the merchant? [`Yes/No`] - **No** — Are there local laws or regulations prohibiting you from resolving with the merchant? [`Yes/No`] - **No** - **Yes** — Please explain. [`Text`] - **Yes** - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

― Service

- _[required]_ Was non-fiat currency or purchase of non-fungible token(s) (NFT), the non-fiat currency or non-fungible token received by the cardholder did not match the description provided at the time of the transaction? [`Yes/No`] - **No** - **Yes** - _[required]_ Is dispute related to the quality of food received from eating places or restaurants? [`Yes/No`] - **No** - **Yes** - _[required]_ Please provide details of what was ordered and not as described. [`Text`] - _[required]_ When did you receive the service? [`Date`] - _[required]_ Did you cancel the service? [`Yes/No`] - **No** - **Yes** — - When did you cancel? [`Date`] - Why did you cancel? [`Text`] - Did the merchant accept the cancellation? [`Yes/No`] - **No** - **Yes** - _[required]_ Did you attempt to resolve with the merchant? [`Yes/No`] - **No** — Are there local laws or regulations prohibiting you from resolving with the merchant? [`Yes/No`] - **No** - **Yes** — Please explain. [`Text`] - **Yes** - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

The terms of sale were misrepresented.

― Merchandise

- _[required]_ Please provide details of what was ordered. [`Text`] - _[required]_ When did you receive the merchandise/service? [`Date`] - _[required]_ How was the merchandise/service misrepresented? [`Text`] - _[required]_ Did you return the merchandise? [`Yes/No`] - **No** — Did you attempt to return the merchandise? [`Yes/No`] - **No** - **Yes** — - When did you attempt to return it? [`Date`] - Please provide a detailed description of how you attempted to return the merchandise. [`Text`] - Where is the merchandise at this time? [`Text`] - Please select one of the options below which best represents the return attempt. [`BulletList`] - The merchant refused to provide return authorization. - The merchant refused to accept the returned merchandise. - The merchant informed not to return the merchandise. - The merchant no longer exists or is not responding. - The merchant did not provide clear instruction on how to return. - **Yes** — - When did you return the merchandise? [`Date`] - Do you know when the merchant received the merchandise? [`Yes/No`] - **No** - **Yes** — - When did the merchant receive the merchandise? [`Date`] - What return method did you use? [`BulletList`] - **Face to Face** - **FedEx** — What was the tracking number? [`Text`] - **DHL** — What was the tracking number? [`Text`] - **UPS** — What was the tracking number? [`Text`] - **Postal Service** — What was the tracking number? [`Text`] - **Other** — Please explain: [`Text`] - _[required]_ Did you attempt to resolve with the merchant? [`Yes/No`] - **No** — Are there local laws or regulations prohibiting you from resolving with the merchant? [`Yes/No`] - **No** - **Yes** — Please explain. [`Text`] - **Yes** - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

― Service

- _[required]_ Please provide a description of what was purchased. [`Text`] - _[required]_ When did you receive the service? [`Date`] - _[required]_ How was the merchandise/service misrepresented? [`Text`] - _[required]_ Did you cancel the service? [`Yes/No`] - **No** - **Yes** — - When did you cancel? [`Date`] - Why did you cancel? [`Text`] - Did the merchant accept the cancellation? [`Yes/No`] - **No** - **Yes** - _[required]_ Did you attempt to resolve with the merchant? [`Yes/No`] - **No** — Are there local laws or regulations prohibiting you from resolving with the merchant? [`Yes/No`] - **No** - **Yes** — Please explain. [`Text`] - **Yes** - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

I was charged or credited incorrectly

_How were you charged or credited incorrectly?_

I was charged the wrong amount

- _[required]_ Are you disputing the full amount of the transaction? [`Yes/No`] - **No** - **Yes** — To dispute a transaction for an incorrect amount, the amount disputed must be less than the full transaction amount. Please go back and choose a new claim reason. - _[required]_ What is the correct amount that should have been charged? [`Text`] - _[required]_ What is the amount shown on your receipt or confirmation? [`Text`] - _[required]_ Is the dispute due to the difference between the quoted price and the actual charges made by the merchant? [`Yes/No`] - **No** - **Yes** - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

I was charged a long time after the transaction occurred

- _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]

***

Invalid Data

***

Incorrect Currency

***

Incorrect Account Number

***

I was charged more than once.

_The duplicate transaction must be selected for the claim reason **Charged More Than Once**._
- _[required]_ Is the valid transaction on this same account? [`Yes/No`] - **No** — Is the other transaction on a Galileo card? [`Yes/No`] - **No** — What was the other form of payment? [`BulletList`] - **Another Visa** - **Another Card** - **Check** - **Cash** - **Other** — Please explain. [`Text`] - **Yes** — - Select the account the charge(s) appear on (`/claim/intake/retrieveOtherAccounts`): [Selector] - Please select a valid transaction. (`/claim/intake/retrieveSimilarTransactions`). [Selector] - **Yes** — Please select a valid transaction. (`/claim/intake/retrieveSimilarTransactions`). [Selector] - _[required]_ Did you attempt to resolve with the merchant? [`Yes/No`] - **No** — Are there local laws or regulations prohibiting you from resolving with the merchant? [`Yes/No`] - **No** - **Yes** — Please explain. [`Text`] - **Yes** - _[required]_ Do you have any additional information that should be provided to the merchant regarding your dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. This will be provided to the merchant. [`Text`] - _[required]_ Do you have any additional information to provide about this dispute? [`Yes/No`] - **No** - **Yes** — Please provide any additional information. [`Text`]