Janata Sahakari Bank Ltd, Dharashiv

Customer Complaint – Unauthorized Transaction

Account Number *

Unauthorized Amount *

Unauthorized Response Code *

Channel Used for Unauthorized Transaction *

ATM Cash Withdrawal E-Commerce POS IMPS Other

Unauthorized Transaction Date *

Unauthorized Transaction Time *

Merchant / ATM Location *

My Card Was in My Possession *

Yes No

Remarks

Declaration

I hereby declare that neither me nor my family member / representative performed / authorized the above transaction(s). I confirm all information is true and agree to charges if the dispute is invalid. I authorize the Bank to deactivate the card.

Janata Sahakari Bank Ltd, Dharashiv (Multi State)

Customer Complaint

Janata Sahakari Bank Ltd, Dharashiv
(Multi State)