< Go Back

Card Dispute Form

Upload necessary documents and fill out the form below related to your dispute claim. Our team will review your submission and work to resolve the issue promptly.

All fields are required. Indicate NA if not applicable. Cardholder Name

Card Number Input your account number if you do not have an ATM card.

Salesforce/Workflow Reference Number

Contact Number

Email Address

Transactions Input the actual merchant name reflected on your Statement of Account (e.g. Netflix, Google Play). Maximum number of disputed transactions is 50. If above 50, upload a separate file as a supporting document containing the list of additional disputed transactions.

Total Disputed Amount

Questionnaire

1. When did you last use your card?

2. Where were you during the alleged unauthorized transactions? (specify the date/s)

3. Have you been out of the country for the past 6 months? If yes, where and how long did you stay there?

4. Where do you normally use your card for the past 3 months (merchant, location of ATM, online facility, etc.)?

5. What bank and location do you usually withdraw cash from?

6. When and how did you discover the unauthorized transactions?

7. If unauthorized transactions happened more than 30 calendar days ago, why were these transactions not reported immediately?

8. Did you ever misplace your card? If yes, when and how did you find out that it was lost?

9. Have you received any notification via email or SMS inquiring about personal details/update on personal information?
Yes No

If yes, did you provide any details?
Yes No
When and how did you receive the call/notification and what are the details or information that you provided? Please provide all relevant information and if possible, upload a copy of the SMS/Email/mobile number received/used.

10. Did you access any website link, online survey, or receive any email that asked for personal and account information? If yes, what are the details or information that you provided?

11. Did you dispose any document/s containing your bank/card account details without shredding them?

12. Have you allowed anybody to use your card? If yes, to whom?

13. Have you given your card or card details (e.g. cardnumber, expiry date, CVV, etc) to someone else? If yes, to whom and what were the details provided?

14. For clients who have RCBC Online Banking accounts, have you shared your username, password, or One-Time Password (OTP) to anyone? This could be via phone call, SMS, links, etc.

Supporting Documents
Upload a scanned copy of your ATM/debit card (front only) used for the disputed transaction/s. If disputed transactions/withdrawals are done overseas/abroad, please also upload a copy of your passport (all 44 pages including blanks). IMPORTANT: Failure to upload a scanned copy of your ATM/Debit card (front only), a list of additional transactions (if more than 50), or a copy of your passport (if applicable) will result in case refiling and delay in resolution. Allowed file types to be uploaded are PDF, TIFF, PNG and JPG only.
You can upload a maximum of 10 files with total file size of 10MB. If you no longer have your card, please tick the checkbox below. I confirm that I no longer have the card with me

CLIENT DISCLOSURE

I hereby declare that all information in this Form, its enclosures, and in any of my emails, messages, and/or phone calls to RCBC in relation to this Form (the “Information”), are true, accurate, genuine and valid. I agree that (a) any disputed transactions that were posted more than ninety (90) days from my submission of this Form shall not be accommodated and shall be considered valid and binding upon me; (b) RCBC shall advise me of the disposition of my claims within sixty (60) days from RCBC’s receipt of this Form; (c) RCBC shall be authorized to share the Information; any relevant data on my card(s), account(s), and transactions; and/or my personal information (name, address, contact information, as applicable) with any third party, including RCBC Bankard Services Corporation, the Merchant(s), Visa, Inc., and/or Mastercard Incorporated, for the purpose of processing, investigating, and verifying my claim; and (d) the corresponding fee of P150.00, at a minimum, for every sales slip retrieval and other related costs that may be incurred in the course of the investigation of my claims in this Form shall be charged to my card(s). I Agree

Please note that the turnaround time for case resolution is 45 banking days upon receipt of complete documents.

Secure Document Exchange

Card Dispute Form

ID

Merchant Name

Transaction Amount

Transaction Date

Action

Questionnaire