Requesting data as Card Issuer

If your cardholder is requesting a chargeback for a transaction that you suspect that he may have placed himself, please fill in the form below to request more information regarding specific transactions.

Please fill in all information below and confirm you have read the documents linked:

Data Transfer Agreement EEA-non EEA: if your company is established outside the European Economic Area

Data Transfer Agreement EEA / EEA: if your company is established inside the European Economic Area

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Company

Land

Data requested

Why do you think that this data was used fraudulently?

How can you benefit from this data?

BIN

Cardholder name

Cardholder phone number

Cardholder email

Expiration date

Date format is yyyy/MM/dd. Press the down arrow or enter key to interact with the calendar and select a date. Press the escape button to close the calendar.

Billing address and Post code

Transaction dates, description & values

Last 4 digits of the payment instrument

DPA Request Form (png, jpg, jpeg format). If you have a pdf file, take a screenshot: (maks.: 1)

Yderligere oplysninger.

By checking this box you confirm that you have read and agreed to the relevant Data Transfer Agreement:

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