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    Credit card disputes customer claim form

    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. This form is for personal cards only. If you’re looking to make a claim on a business card, you will need to contact the number on the back of your card.

    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 45 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.

    This form may not work on some browsers, for example Internet Explorer 11. If you can’t complete the form successfully, please update your browser or contact our team using the number on the back of your card. Follow this link to find out how to upgrade your browser.

    Dispute details

     

    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.

    Reset

    I have purchased goods or services that I have not received (including flights, holidays etc...).

     

    Goods / Services not received

    Sorry, we're unable to proceed with your claim.

    To help you dispute this payment we need you to first try and contact the merchant. If the merchant has failed to provide contact information, is not responding, or has ceased trading please tick 'Yes'.

     

    Sorry, we're unable to proceed with your claim.

    If the merchant is willing to assist then we advise that you attempt to resolve the dispute with them in the first instance. If you are unable to get in contact with the merchant as they have failed to provide contact information or are not responding, please tick 'Yes'.

     

    Day
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    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.lloydsbank.com/online-banking/internet-banking/using-internet-banking/personal-details.html.

    Transaction details

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

    Day
    Month
    Year
    £
    £

    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)

     

    Day
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    Day
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    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

    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.lloydsbank.com/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
    Day
    Month
    Year

    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.lloydsbank.com/online-banking/internet-banking/using-internet-banking/personal-details.html.

    Transaction details

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

    Day
    Month
    Year
    £
    £
    Day
    Month
    Year

    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.lloydsbank.com/online-banking/internet-banking/using-internet-banking/personal-details.html.

    Transaction details

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

    Day
    Month
    Year
    £
    £

    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

    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.lloydsbank.com/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
    Day
    Month
    Year

    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.lloydsbank.com/online-banking/internet-banking/using-internet-banking/personal-details.html.

    Transaction details

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

    Day
    Month
    Year
    £
    £

    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

    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.lloydsbank.com/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 received goods or services that are not as described or of the expected quality.

     

    Sorry, we're unable to proceed with your claim.

    To help you dispute this payment we need you to first try and contact the merchant. If the merchant has failed to provide contact information, is not responding, or has ceased trading please tick 'Yes'.

    Sorry, we're unable to proceed with your claim.

    We can only dispute the payment once the merchant has been contacted and confirmed they are unwilling to assist.

     

    Day
    Month
    Year

    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.lloydsbank.com/online-banking/internet-banking/using-internet-banking/personal-details.html.

    Transaction details

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

    Day
    Month
    Year
    £
    £

    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.

     

    Day
    Month
    Year
    Day
    Month
    Year
    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.lloydsbank.com/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
    Day
    Month
    Year

    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.lloydsbank.com/online-banking/internet-banking/using-internet-banking/personal-details.html.

    Transaction details

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

    Day
    Month
    Year
    £
    £

    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.

     

    Day
    Month
    Year
    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.lloydsbank.com/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.

     

    Day
    Month
    Year

    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.lloydsbank.com/online-banking/internet-banking/using-internet-banking/personal-details.html.

    Transaction details

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

    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.lloydsbank.com/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.

     

    Sorry, we're unable to proceed with your claim.

    To help you dispute this payment we need you to first try and contact the merchant. If the merchant has failed to provide contact information, is not responding, or has ceased trading please tick 'Yes'.

    Sorry, we're unable to proceed with your claim.

    We can only dispute the payment once the merchant has been contacted and confirmed they are unwilling to assist.

     

    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.lloydsbank.com/privacy.

     

    Day
    Month
    Year

    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.lloydsbank.com/online-banking/internet-banking/using-internet-banking/personal-details.html.

    Transaction details

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

    Day
    Month
    Year
    £
    £

    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.

     

    Sorry, we're unable to proceed with your claim.

    To help you dispute this payment we need you to first try and contact the merchant. If the merchant has failed to provide contact information, is not responding, or has ceased trading please tick 'Yes'.

    Sorry, we're unable to proceed with your claim.

    We can only dispute the payment once the merchant has been contacted and confirmed they are unwilling to assist.

     

    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.

     

    Day
    Month
    Year

    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.lloydsbank.com/online-banking/internet-banking/using-internet-banking/personal-details.html.

    Transaction details

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

    Day
    Month
    Year
    £
    £
    Day
    Month
    Year
    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.lloydsbank.com/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.

     

    Day
    Month
    Year

    Transaction details

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

    Day
    Month
    Year
    £
    £
    Day
    Month
    Year
    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.lloydsbank.com/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