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Get and Sign Green Dot Dispute Form
Dispute P. O. Box 1187 Monrovia CA 91017 Section A Cardholder Information Please provide all of the following pieces of information and sign the form where indicated Cardholder s Name 2nd Cardholder s Name if applicable Card Number Daytime Phone - Mailing Address This is a new address. Section B Transaction Information Transaction Amount. Date of Transaction // Merchant s Name Have you contacted the merchant Yes No Page 1 of 3 Section C Dispute Reason Please read each of the following...Show details
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