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[Your address] 

[Debit/ Credit card company address]

Dear [customer services manager's name],

Claim under Visa Chargeback Scheme rules –

I am writing to you in connection with the purchase of [insert details] on [date] from [details of seller]. I enclose the following documentation which provides details of the transaction:

[List documents e.g. invoices, receipts, details of estimated delivery dates that you are submitting with the Chargeback claim.]

I paid for [insert details] using my [insert supplier name] [debit] [credit] card.

The total cost of [insert details] was [£xx].

In breach of contract [insert details of the problem – see our guide to Chargeback for details of what can and can't be claimed using Chargeback].

The transaction for the purchase of [insert details] was less than 120 days ago and accordingly, I am writing to request a refund of the above amounts under the Chargeback Scheme rules.

I look forward to your prompt response.

Yours sincerely,

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