If you believe that a transaction on your statement is in error you can use this form to contact the Credit Card Programs Department. Regulations require that you notify them in writing within 60 days from the statement billing date of the disputed charge. Any response received after this time frame may result in our inability to assist you with your dispute. Please be advised that Visa & MasterCard require that attempts be made to resolve your dispute with the merchant before notifying them. Please complete and email or fax this form to Manager of Credit Card Programs, at email@example.com or fax: 315-443-1986.