龙卡信用卡疑义交易声明(Declaration) 卡号CARD NO: 姓名 ACC NAME: 交易日期 商户名称 MERCHANT NAME 金额 TRANS AMOUNT 本人对上述交易做出以下投诉 I dispute the above transaction(s) for the following reason(s)。Please investigate the matter: 1、本人并无授权过上述交易。 I have neither authorized nor participated in these transactions. 2、重复收款。 I was charged twice. 3、交易金额不符,正确应为。 Amount should be 4、本人曾于上述商户签购笔交易金额,但并未签购过上述交易,且本人的信用卡从未遗失。 I signed in transactions for at the named merchant,but I didn’t sign in the above transaction(s) and my card was in my possession. 5、本人确曾向上述酒店定房,但本人已于(日期,时间)向酒店取消定房并取得一取消号码。 I made a room reservation with hotel and canceled it at (AM/PM) on (date) 。I was given the cancellation No . 6、本人收到商户签发的退款单,但该款至今仍未记入本人账户。 I received a credit slip from the merchant but the credit doesn’t appear in my statement. 7、本人已用其他方式付款( )现金、( )支票、( )其他信用卡。(请附收据副本)。 I paid the transaction by ( ) cash、( ) check、( ) other credit card.(Please enclose the payment receipt copy). 8、上述商户无法或不愿向本人提供有关交易的服务(请于备注栏内详细说明及附有关文件)。 The merchant was unable or unwilling to provide the services requested. (please explain the details in ments Section and enclose supporting document). 9、本人已于(日期) 书面向上述商户提出取消自动转账授权,但该商户未按照办理(请附文件副本)。 I informed the merchant to cancel my monthly/yearly agreement by writing on (date) (please enclose document copy ). Nevertheless, my account still billed. 10、本人未曾收到在以上商户订购的货物。
