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Include a dispute reason and any required supporting explanation.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How do I submit the dispute form to TASC?",{"text":68,"@type":64},"Submit the completed, signed form to TASC via Online Service Request, fax, or mail. 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Please complete, sign, date, and return the completed form along with any pertinent documents to TASC. *\u003Cbr>2. DO NOT include your FULL 16 digit Card Number anywhere on this form, due to security reasons!\u003Cbr>3. The completed Form must be received by TASC within 120 days of the unauthorized transaction date.\u003Cbr>4. Please retain a copy of the completed form for your own records.\u003Cbr>5. Should you have any questions or need further assistance, please contact TASC Customer Care at:\u003Cbr>608-241-1900 or 800-422-4661. Please have your TASC ID available.\u003Cbr>*This TASC Card Transaction Dispute Form is provided for the cardholder’s convenience. In lieu of this form, the cardholder may submit, in writing, all of the necessary information as suggested on this form, to include, but not limited to, Card Holder Name, Card Holder Address, Transaction Date, Transaction Amount, Merchant Name and Reason for Dispute. |  |  |  |\n| Submit this completed form to TASC via Online Service Request, fax or mail: | Online Service Request | Fax | Mail |\n|  | Log onto your online account and attach completed form via Support Request\u003Cbr>[www.tasconline.com](www.tasconline.com) (click Contact Us) | (608) 245-3623 | TASC, PO Box 7308 Madison, Wisconsin 53704-7308 |\n\nCARD/ACCOUNTHOLDER INFORMATION  \n\n|  12 Digit TASC ID \\# (NOT Card Number):  |  |  |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| First Name: |  |  | MI: |  | Last Name: |  |  |  |  |\n| Email Address: |  |  |  |  |  |  |  |  |  |\n| Primary Phone \\#: |  |  | Mobile Phone \\#: |  |  |  |  |  |  |\n| Primary Address: | Address Line 1: |  |  |  |  |  |  | Apt: |  |\n|  | Address Line 2: |  |  |  |  |  |  |  |  |\n|  | City: |  |  |  |  |  |  |  |  |\n|  | State: |  |  |  | ZIP/Postal Code: |  |  | +4 |  |\n\nTRANSACTION DISPUTE INFORMATION  \nPlease complete the transaction information below, based on the card used for the disputed transaction(s) .  \n\n| LAST 4 DIGITS OF CARD \\# | NAME OF CARDHOLDER | TRANSACTION DATE | TRANSACTION AMOUNT $ | MERCHANT NAME |\n| --- | --- | --- | --- | --- |\n|  |  |  |  |  |\n|  |  |  |  |  |\n|  |  |  |  |  |\n|  |  |  |  |  |\n|  |  |  |  |  |\n|  |  |  |  |  |\n\n**AUTHORIZATION SIGNATURE REQUIRED ON PAGE 2 **  \nREASON FOR DISPUTE  \nPlease select one reason below and complete the applicable information:  \n☐ I certify that the charge(s) listed above were not made by me, nor any person authorized by me to use my card.  \nInclude a statement detailing the circumstances surrounding the fraud claim.  \n_________________________________________________________________________________________________  \n_________________________________________________________________________________________________  \n\n| Was your card stolen? | ☐ Yes ☐ No | Was a police report filed? | ☐ Yes ☐ No |\n| --- | --- | --- | --- |\n\n☐ I have not received the merchandise or services represented by the disputed transaction(s) . The expected date of delivery was   .  \n☐ I notified the merchant to cancel my monthly/yearly agreement on   Since then my TASC Card has been charged   times.  \n☐ The amount entered on the sales receipt was increased from $  to $   \n☐ I did not receive credit from the enclosed credit voucher/receipt within 45 calendar days from the date it was issued to me by the merchant.  \n☐ Double or multiple charges.  \n☐ Other: Please provide explanation below or include a letter with a detailed explanation of the reason for the dispute:  \n_________________________________________________________________________________________________  \n_________________________________________________________________________________________________  \n\n| AUTHORIZATION |\n| --- |\n| ☐ By checking this box, under penalty of perjury, I declare that the foregoing is true and correct.\u003Cbr>Accountholder Signature Date |\n| DISPUTE PROCESS |\n\n• Completed Transaction Dispute Form, including signature and date, must be received by TASC within 1","cbCaioGLy9ieLiUi","https://ap.wps.com/l/cbCaioGLy9ieLiUi","pdf",355996,"English","# Card/Accountholder Information\n# Transaction Dispute Information\n# Reason for Dispute\n# Authorization\n# Dispute Process","[{\"question\":\"What information must be included with the TASC Card Transaction Dispute Form?\",\"answer\":\"Provide cardholder details and the transaction information, including last 4 digits of the card, transaction date, transaction amount, and merchant name. Include a dispute reason and any required supporting explanation.\"},{\"question\":\"How do I submit the dispute form to TASC?\",\"answer\":\"Submit the completed, signed form to TASC via Online Service Request, fax, or mail. Online submission requires attaching the completed form to a Support Request.\"},{\"question\":\"What is the deadline for submitting a dispute?\",\"answer\":\"TASC requires the completed dispute form to be received within 120 days of the unauthorized transaction date.\"}]","TASC Card Transaction Dispute Form - Complete, Sign, and Submit within 120 Days | PDF"]