Credit card disputes customer claim form

If your travel has been disrupted by coronavirus use our handy travel disruption tool before completing this form to check this is the right option for you.

This form is to help you make a claim on a credit card purchase you've made. Please fill in the below form to allow us to review and process your claim. We may need to get in touch with you for supporting documents, so please check that the form is filled out with accurate and up-to-date information. Failure to provide accurate information will impact the outcome of your dispute and our ability to recover your funds.

If you have already submitted a claim to us, via this form or our telephony service, there is no need to submit another form. We aim to review all claims within 10 working days and we will get in touch with you if we require any further information or if we have any updates.

If your dispute relates to travel services that the merchant has cancelled and are unable to provide, please ensure that you are selecting 'I have purchased goods or services that I have not received' and are ticking 'Yes' to 'Does your dispute relate to travel services?'. This will help us capture all of the information that we require to review your travel claim.

Please be aware that in most instances we will need you to try and resolve with the merchant before raising a claim with us. Please provide information on your attempts to resolve with the merchant when completing the form.

This form cannot be used to dispute suspected fraudulent transactions - if you don't recognise a payment that has been made using your credit card, please contact our telephony team using the number on the back of your card.

You need to make a claim for a chargeback within a set time period, usually around 4 months from the date of purchase, or from when the goods or services were expected to be received. If it's been more than 8 weeks since that date, please call us on 0345 944 4555 or +44 1733 573 189 (from outside the UK). Lines are open 7am to 11pm, seven days a week. Further details on your chargeback rights and additional protection for credit card purchases under Section 75 of the Consumer Credit Act are available in the Travel FAQs.

If it's been less than 8 weeks, please continue to complete the details below.

Dispute details

First name

Surname

Date of birth

Day

Month

Year

Address Line 1

Address Line 2

Address Line 3

Post code

Last four digits of card (the long number)

Please ensure the contact email address and mobile phone number you provide are the details that we hold for you, as they may be used to contact you regarding this claim.

To check what details we hold you can visit - https://www.halifax.co.uk/helpcentre/manage-your-details.html.

Registered email address

Confirm registered email address

Registered mobile phone number

Confirmed registered mobile phone number

Transaction details

Please provide these details exactly as they appear on your statement.

Merchant name

Transaction date (DD/MM/YYYY)

Day

Month

Year

Transaction amount (sterling pounds and pence)

£

Claim amount (sterling pounds and pence) this should not exceed the transaction amount

£

Goods/Services Not Received - Travel Services

Within the boxes below, please provide a full breakdown of your attempts to resolve with the merchant. We will require dates of contact, contact method used (e.g. Email) and a summary of the merchant response.

Please populate every field that is applicable to the travel services that you have purchased. Ensure that you are providing as much detail as possible as this will mean we are less likely to contact you for further information. If you have any evidence that you feel may assist with your dispute then please let us know.

What we need you to tell us on this form:

Package holiday or flight with accommodation, we need to know: If travel service was included e.g. flights, name of accommodation, description of accommodation e.g. all inclusive villa, where accommodation is, have you been offered/accepted vouchers from the merchant.
Flights only, we need to know: flight no, single or return, departure/return dates, airport going from & to, any extras e.g. luggage/leg room.
Accommodation, we need to know: What is the name of your accommodation, location of accommodation (country/area), start and end date. Description of what it included e.g. meals/half board/full board/self catering), holidays: extra car hire/excursions.
Other services e.g. car hire, we need to know: date due to receive these services, why didn’t receive service.
Liquidation, we need to know – Is your trip covered by ATOL/ABTA, this is often found at bottom of your booking receipt, have they confirmed they won’t cover your claim, how you became aware you wouldn’t get a refund.
Vouchers, we need to know – have you been offered/accepted vouchers from the merchant.

For all claims please tell us:

What was the method of contact?
When was your last attempt to communicate with the merchant?
Please provide a brief summary of the merchant’s response? (If No response, please specify)

Please provide details of what you purchased (E.g. Package Holidays/Flights Only/Additional Extras)

Was the booking a single or return journey?

Single

Return

What was the departure date?

Day

Month

Year

Which airports were you flying to and from?

Please provide a detailed description of the accommodation, if no accommodation please enter 'none'. (E.g. hotel name, length of stay, etc.)

How many people did you book for?

Why we need this information: – The information provided helps us raise a claim with the travel provider, without this information we won’t be able to help you & your claim may be rejected.

Provide details of who cancelled the trip, if it was the provider or yourself
How and when were you notified, if you cancelled did the cancellation rights allow this.
You should include the flight number

Provide any additional information that you have (e.g. Merchant contact outcome or transfer details)

Your personal data will only be used for the purposes of reviewing and servicing your dispute. For further information about how we use your personal data please visit https://www.halifax.co.uk/privacy.

If you decide to change any of your answers in the drop down above please refresh the page first to ensure your information is accurately recorded.

Submit

First name

Surname

Date of birth

Day

Month

Year

Address Line 1

Address Line 2

Address Line 3

Post code

Last four digits of card (the long number)

Please ensure the contact email address and mobile phone number you provide are the details that we hold for you, as they may be used to contact you regarding this claim.

To check what details we hold you can visit - https://www.halifax.co.uk/helpcentre/manage-your-details.html.

Registered email address

Confirm registered email address

Registered mobile phone number

Confirmed registered mobile phone number

Transaction details

Please provide these details exactly as they appear on your statement.

Merchant name

Transaction date (DD/MM/YYYY)

Day

Month

Year

Transaction amount (sterling pounds and pence)

£

Claim amount (sterling pounds and pence) this should not exceed the transaction amount

£

First name

Surname

Date of birth

Day

Month

Year

Address Line 1

Address Line 2

Address Line 3

Post code

Last four digits of card (the long number)

Please ensure the contact email address and mobile phone number you provide are the details that we hold for you, as they may be used to contact you regarding this claim.

To check what details we hold you can visit - https://www.halifax.co.uk/helpcentre/manage-your-details.html.

Registered email address

Confirm registered email address

Registered mobile phone number

Confirmed registered mobile phone number

Transaction details

Please provide these details exactly as they appear on your statement.

Merchant name

Transaction date (DD/MM/YYYY)

Day

Month

Year

Transaction amount (sterling pounds and pence)

£

Claim amount (sterling pounds and pence) this should not exceed the transaction amount

£

Goods/Services Not Received - Goods

What was the method of contact?
When was your last attempt to communicate with the merchant?
Please provide a brief summary of the merchant’s response? (If No response, please specify)
Describe the goods you ordered e.g. the make, colour, size and quantity.
Provide the delivery address for the goods.

Please note: If your dispute relates to travel, select Yes to the Travel Services question at the top of this form

Description of what has been purchased and where it was to be delivered to (refer to checklist above).

What was the expected delivery date of the goods?

Day

Month

Year

Description of why the goods have not been received (Failed to deliver, order cancelled, etc.)

Your personal data will only be used for the purposes of reviewing and servicing your dispute. For further information about how we use your personal data please visit https://www.halifax.co.uk/privacy.

If you decide to change any of your answers in the drop down above please refresh the page first to ensure your information is accurately recorded.

Submit

First name

Surname

Date of birth

Day

Month

Year

Address Line 1

Address Line 2

Address Line 3

Post code

Last four digits of card (the long number)

Please ensure the contact email address and mobile phone number you provide are the details that we hold for you, as they may be used to contact you regarding this claim.

To check what details we hold you can visit - https://www.halifax.co.uk/helpcentre/manage-your-details.html.

Registered email address

Confirm registered email address

Registered mobile phone number

Confirmed registered mobile phone number

Transaction details

Please provide these details exactly as they appear on your statement.

Merchant name

Transaction date (DD/MM/YYYY)

Day

Month

Year

Transaction amount (sterling pounds and pence)

£

Claim amount (sterling pounds and pence) this should not exceed the transaction amount

£

Goods/Services Not Received - Services

What was the method of contact?
When was your last attempt to communicate with the merchant?
Please provide a brief summary of the merchant’s response? (If No response, please specify)
Describe the services you ordered e.g Netflix, Amazon, consultancy work, binary trading.
Provide the delivery address for the goods

Please note: If your dispute relates to travel, select Yes to the Travel Services question at the top of this form

Description of what has been purchased (refer to checklist above).

What was the expected start date for services?

Day

Month

Year

Description of why the services have not been received (Failed to deliver, order cancelled, etc.)

Your personal data will only be used for the purposes of reviewing and servicing your dispute. For further information about how we use your personal data please visit https://www.halifax.co.uk/privacy.

If you decide to change any of your answers in the drop down above please refresh the page first to ensure your information is accurately recorded.

Submit

First name

Surname

Date of birth

Day

Month

Year

Address Line 1

Address Line 2

Address Line 3

Post code

Last four digits of card (the long number)

Please ensure the contact email address and mobile phone number you provide are the details that we hold for you, as they may be used to contact you regarding this claim.

To check what details we hold you can visit - https://www.halifax.co.uk/helpcentre/manage-your-details.html.

Registered email address

Confirm registered email address

Registered mobile phone number

Confirmed registered mobile phone number

Transaction details

Please provide these details exactly as they appear on your statement.

Merchant name

Transaction date (DD/MM/YYYY)

Day

Month

Year

Transaction amount (sterling pounds and pence)

£

Claim amount (sterling pounds and pence) this should not exceed the transaction amount

£

Goods/Services Not as Described - Goods

What was the method of contact?
When was your last attempt to communicate with the merchant?
Please provide a brief summary of the merchant’s response? (If No response, please specify)
Describe the goods you ordered e.g. the make, colour, size and quantity.
Provide the delivery address for the goods.

Please select the travel option to tell us about travel services / holidays you have not received.

Date you received the goods

Day

Month

Year

Please provide a detailed description of what you have purchased (refer to checklist above).

Please provide a detailed description of what you have received

Have you returned the goods to the merchant?

Yes

No

Date the goods were returned to the merchant

Day

Month

Year

Date the goods were received by the merchant

Day

Month

Year

Which shipping company did you use to return the goods?

Submit

First name

Surname

Date of birth

Day

Month

Year

Address Line 1

Address Line 2

Address Line 3

Post code

Last four digits of card (the long number)

Please ensure the contact email address and mobile phone number you provide are the details that we hold for you, as they may be used to contact you regarding this claim.

To check what details we hold you can visit - https://www.halifax.co.uk/helpcentre/manage-your-details.html.

Registered email address

Confirm registered email address

Registered mobile phone number

Confirmed registered mobile phone number

Transaction details

Please provide these details exactly as they appear on your statement.

Merchant name

Transaction date (DD/MM/YYYY)

Day

Month

Year

Transaction amount (sterling pounds and pence)

£

Claim amount (sterling pounds and pence) this should not exceed the transaction amount

£

Goods/Services Not as Described - Services

What was the method of contact?
When was your last attempt to communicate with the merchant?
Please provide a brief summary of the merchant’s response? (If No response, please specify)
Describe the services you ordered e.g Netflix, Amazon, consultancy work, binary trading.
Provide the delivery address for the goods

Please select the travel option to tell us about travel services / holidays you have not received.

Date you received the services

Day

Month

Year

Please provide a detailed description of what you have purchased (refer to checklist above).

Please provide a detailed description of what you have received.

Date the services were cancelled

Day

Month

Year

Your personal data will only be used for the purposes of reviewing and servicing your dispute. For further information about how we use your personal data please visit https://www.halifax.co.uk/privacy.

If you decide to change any of your answers in the drop down above please refresh the page first to ensure your information is accurately recorded.

Submit

I did not receive my cash from an ATM abroad.

First name

Surname

Date of birth

Day

Month

Year

Address Line 1

Address Line 2

Address Line 3

Post code

Last four digits of card (the long number)

Please ensure the contact email address and mobile phone number you provide are the details that we hold for you, as they may be used to contact you regarding this claim.

To check what details we hold you can visit - https://www.halifax.co.uk/helpcentre/manage-your-details.html.

Registered email address

Confirm registered email address

Registered mobile phone number

Confirmed registered mobile phone number

Transaction details

Please provide these details exactly as they appear on your statement.

Merchant name

Transaction date (DD/MM/YYYY)

Day

Month

Year

Transaction amount (sterling pounds and pence)

£

Claim amount (sterling pounds and pence) this should not exceed the transaction amount

£

Your personal data will only be used for the purposes of reviewing and servicing your dispute. For further information about how we use your personal data please visit https://www.halifax.co.uk/privacy.

If you decide to change any of your answers in the drop down above please refresh the page first to ensure your information is accurately recorded.

Submit

I have been charged incorrectly (incorrect amount / more than once).

Within the boxes below, please provide a full breakdown of your attempts to resolve with the merchant. We will require dates of contact, contact method used (e.g. Email) and a summary of the merchant response.

Have you contacted the merchant to try and resolve your dispute?

Yes

No

Please provide a detailed description of what you have purchased (refer to checklist above).

Please detail how you have been made aware that you have been charged an incorrect amount.

Your personal data will only be used for the purposes of reviewing and servicing your dispute. For further information about how we use your personal data please visit https://www.halifax.co.uk/privacy.

First name

Surname

Date of birth

Day

Month

Year

Address Line 1

Address Line 2

Address Line 3

Post code

Last four digits of card (the long number)

Please ensure the contact email address and mobile phone number you provide are the details that we hold for you, as they may be used to contact you regarding this claim.

To check what details we hold you can visit - https://www.halifax.co.uk/helpcentre/manage-your-details.html.

Registered email address

Confirm registered email address

Registered mobile phone number

Confirmed registered mobile phone number

Transaction details

Please provide these details exactly as they appear on your statement.

Merchant name

Transaction date (DD/MM/YYYY)

Day

Month

Year

Transaction amount (sterling pounds and pence)

£

Claim amount (sterling pounds and pence) this should not exceed the transaction amount

£

If you decide to change any of your answers in the drop down above please refresh the page first to ensure your information is accurately recorded.

Submit

I have cancelled a booking/order/service and I am still being charged - Goods

Within the boxes below, please provide a full breakdown of your attempts to resolve with the merchant. We will require dates of contact, contact method used (e.g. Email) and a summary of the merchant response.

First name

Surname

Date of birth

Day

Month

Year

Address Line 1

Address Line 2

Address Line 3

Post code

Last four digits of card (the long number)

Please ensure the contact email address and mobile phone number you provide are the details that we hold for you, as they may be used to contact you regarding this claim.

To check what details we hold you can visit - https://www.halifax.co.uk/helpcentre/manage-your-details.html.

Registered email address

Confirm registered email address

Registered mobile phone number

Confirmed registered mobile phone number

Transaction details

Please provide these details exactly as they appear on your statement.

Merchant name

Transaction date (DD/MM/YYYY)

Day

Month

Year

Transaction amount (sterling pounds and pence)

£

Claim amount (sterling pounds and pence) this should not exceed the transaction amount

£

Please provide a detailed description of what you have purchased.

Have you received the goods?

Yes

No

Date the goods were delivered or due to be delivered

Day

Month

Year

Date the order was cancelled

Day

Month

Year

Have you been billed more than once since cancellation?

Yes

No

Your personal data will only be used for the purposes of reviewing and servicing your dispute. For further information about how we use your personal data please visit https://www.halifax.co.uk/privacy.

If you decide to change any of your answers in the drop down above please refresh the page first to ensure your information is accurately recorded.

Submit

I have cancelled a booking/order/service and I am still being charged - Bookings and Services

Within the boxes below, please provide a full breakdown of your attempts to resolve with the merchant. We will require dates of contact, contact method used (e.g. Email) and a summary of the merchant response.

First name

Surname

Date of birth

Day

Month

Year

Address Line 1

Address Line 2

Address Line 3

Post code

Last four digits of card (the long number)

Registered email address

Confirm registered email address

Registered mobile phone number

Confirmed registered mobile phone number

Transaction details

Please provide these details exactly as they appear on your statement.

Merchant name

Transaction date (DD/MM/YYYY)

Day

Month

Year

Transaction amount (sterling pounds and pence)

£

Claim amount (sterling pounds and pence) this should not exceed the transaction amount

£

Provide a description of what you purchased, the cancellation policy and reason for cancellation.

Date the services were first received.

Day

Month

Year

Date the services were cancelled.

Day

Month

Year

Have you been billed more than once since cancellation?

Yes

No

Your personal data will only be used for the purposes of reviewing and servicing your dispute. For further information about how we use your personal data please visit https://www.halifax.co.uk/privacy.

If you decide to change any of your answers in the drop down above please refresh the page first to ensure your information is accurately recorded.

Submit

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