Chargeback Dispute Letter Template

[Merchant/Business Name]
[Business Address]
[City, State, ZIP]
[Phone] | [Email] | [Website]

Date: [Date]

To: [Bank/Processor Name]
Re: Chargeback Dispute – Request for Reversal
Merchant Account ID (Optional): [MID]
Case/Chargeback ID: [Case ID]

1. Transaction Details

• Cardholder Name: [Name]

• Transaction Date: [Date]

• Transaction Amount: $[Amount]

• Transaction ID: [Transaction ID]

• Order/Invoice Number: [Order #]

• Reason Code (If Known): [Reason code and description]

• Product/Service Purchased: [Description]

• Delivery/Service Date: [Date]

2. Summary of Dispute

We respectfully dispute this chargeback because [brief reason: the goods/services were delivered as described / the customer authorized the transaction / the refund policy was disclosed and acknowledged / the charge is not duplicate / other].

3. Facts Supporting Our Position

3.1 Order and Authorization.

• The customer placed the order on [Date] using [checkout method] and received an order confirmation at [Email].

• The transaction was authorized on [Date/Time] with authorization code [Code] (if available).

3.2 Delivery / Service Completion.

• Delivery was completed on [Date] to [Address], confirmed by: ☐ Carrier proof of delivery ☐ Signature confirmation ☐ Tracking number [Tracking].

• For digital goods/services: access was provided on [Date], with evidence including: ☐ Login/access logs ☐ IP address [IP] ☐ Download timestamp [Time] ☐ Account activity.

3.3 Customer Communications.

• On [Date], the customer contacted us regarding [issue], and we responded on [Date].

• The customer acknowledged receipt/usage on [Date] (if applicable).

3.4 Policies Disclosed.
Our refund/cancellation policy was displayed at checkout and available at: [URL or location]. The customer agreed to the policy on [Date] via: ☐ Checkbox ☐ Terms acceptance ☐ Signed agreement.

3.5 Refund Status.

• ☐ No refund was requested prior to the chargeback.

• ☐ A refund was offered on [Date], but the customer declined.

• ☐ A refund was issued on [Date] in the amount of $[Amount] (attach proof), which makes the chargeback improper as a duplicate remedy.

4. Supporting Documents Attached

We have attached the following evidence:

• ☐ Order confirmation / invoice

• ☐ Receipt / payment confirmation

• ☐ Proof of delivery (tracking, signature, carrier confirmation)

• ☐ Service completion records

• ☐ Digital access logs (if applicable)

• ☐ Customer communications (emails, chat transcripts)

• ☐ Refund/cancellation policy proof and acceptance

• ☐ Customer identity verification (AVS/CVV results, if allowed)

• ☐ Other: [List]

5. Requested Resolution

Based on the documentation above, we respectfully request that the chargeback be reversed and the funds returned to our merchant account.

6. Contact

If additional information is needed, please contact:
Name: [Name]
Title: [Title]
Phone: [Phone]
Email: [Email]

Sincerely,
[Authorized Name]
[Title]
[Merchant/Business Name]

Signatures

[Authorized Name]
Title: [Title]
Date: [Date]
Signature: ___________________________