Dispute transaction 13

How does the Retailer / Merchant name appear on your statement? * Please type exactly as it appears on your statement, otherwise your claim might be rejected. Exclude these special characters: % ; < = > ^ | £

Please Enter the retailer name

Transaction details

What was the date of the transaction? * We'll need the date shown on your statement.

Please enter Valid Date

What was the transaction amount? * We'll need the exact amount shown on your statement (please include euros & cents e.g. €99.99).

Please enter a valid amount

- Remove entry

If the retailer has taken more than one transaction since your cancellation date, please add them here.

+ Add another transaction

Please let us know more about this instalment or payment plan

When did you cancel it? *

Please enter valid date