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Get Cimb Bank Dispute Declaration 2013

– 20953690 Cardholder Name : _____________________________________ Credit Card No : No - - - Merchant Name Transaction Date Amount (RM) 1 2 3 Please tick one category that best describe your reason for disputing the transaction(s). □ □ □ □ □ □ □ □ □ I certify that the above charge was neither made nor authorized by me or my supplementary cardholder. I have been charged __ _ _ times for the same transaction. I participated in only ONE transaction at the above mer.

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