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Date:
Bank Name:
Street Address:
City, State & Zip:
Re: Bank Account #
Dear Sir/Madam:
I am writing to dispute unauthorized transaction(s) regarding my bank account. The following transactions have been improperly processed through my bank account:
Date of Transaction Transaction Description Amount of Transaction
1. ________________ ______________________________ _____________________
2. ________________ ______________________________ _____________________
3. ________________ ______________________________ _____________________
I did not authorize these transactions. Please investigate the above transactions and report the results of your investigation to me at my address which is listed below. Please correct these error(s) to my bank account as soon as possible.
My full name is: _______________________________________________________
My phone number is: ___________________________________________________
My address is: ________________________________________________________
City: ______________________________ State: _______ Zip Code: _____________
Thank you for your prompt attention in this matter.
Sincerely,
________________________________________
(Your Signature)
________________________________________
(Your Name Printed)
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