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Chargeback Evidence Letter

Build your chargeback evidence letter

Organise transaction facts, merchant contact and supporting evidence for a chargeback or card dispute.

1. Your / organisation details

Your name *Organisation / businessAddressEmailPhone

2. Recipient and reference

Card provider / dispute contactBank / card providerRecipient addressDispute / transaction reference

Start from a complete exampleChoose the closest situation. Everything remains editable.

Keep the names and contact details already entered

3. Transaction and dispute detailsBuild the core document from the relevant facts. Options insert only into fields in this section.

Document dateChargeback evidence subjectTransaction and dispute background *Transaction / merchant facts *Purchase / delivery / contact datesMerchant response / dispute status

4. Evidence, impact and outcomeKeep evidence, impact and the requested result separate so the finished document stays easy to follow.

Evidence suppliedFinancial impactChargeback / dispute outcome requested *Review timescale

SignatureSign electronically now or leave signature lines for after download.

How would you like to sign?

Signer name *Role / signing capacity

Electronic signature *

No signature created yet

Creating the signature also confirms it for this document. You can untick the confirmation below if you need to change it.

Date signed *I confirm this electronic signature is mine, I intend to sign electronically, and I approve this document.

Documents and imagesEvidence is fitted to A4 pages inside the document margins. Longer readable documents are automatically continued over as many evidence pages as needed.

PDF, Word, text, JPG, PNG or WebP · up to 10 MB each · up to 12 source files

Supporting pagesAdd another editable A4 page for extra information.

A4 document previewChargeback Evidence Letter · Standard · exact purchase preview

Chargeback Evidence Letter

Standard document

Standard · Section page 1

Chargeback Evidence Letter

Organise transaction facts, merchant contact and supporting evidence for a chargeback or card dispute.

1. Your / organisation details

__SSP_GLOBAL_FLOW_MARKER__

Your name

Organisation / business

Address

Email

Phone

2. Recipient and reference

__SSP_GLOBAL_FLOW_MARKER__

Card provider / dispute contact

Bank / card provider

Recipient address

Dispute / transaction reference

3. Transaction and dispute details

__SSP_GLOBAL_FLOW_MARKER__

Document date

Chargeback evidence subject

Transaction and dispute background

Transaction / merchant facts

Purchase / delivery / contact dates

Merchant response / dispute status

4. Evidence, impact and outcome

__SSP_GLOBAL_FLOW_MARKER__

Evidence supplied

Financial impact

Chargeback / dispute outcome requested

Review timescale

Electronic signature

Signer

Capacity

Signature

Date

Standard · Section page 1

Chargeback Evidence Letter

Organise transaction facts, merchant contact and supporting evidence for a chargeback or card dispute.

1. Your / organisation details

__SSP_GLOBAL_FLOW_MARKER__

Your name

Organisation / business

Address

Email

Phone

2. Recipient and reference

__SSP_GLOBAL_FLOW_MARKER__

Card provider / dispute contact

Bank / card provider

Recipient address

Dispute / transaction reference

3. Transaction and dispute details

__SSP_GLOBAL_FLOW_MARKER__

Document date

Chargeback evidence subject

Transaction and dispute background

Transaction / merchant facts

Purchase / delivery / contact dates

Merchant response / dispute status

4. Evidence, impact and outcome

__SSP_GLOBAL_FLOW_MARKER__

Evidence supplied

Financial impact

Chargeback / dispute outcome requested

Review timescale

Electronic signature

Signer

Capacity

Signature

Date