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ATM Card Online Dispute Reporting Form
(For Bank AL Habib Customers only)
 
All fields are mandatory
 
Nature of Dispute:
 
Customer Details:
City :
Branch :
Account Number : - - - -
Title of A/c :
ATM Card Number :
Contact Number :
Cell: -  
PTCL: -
(e.g. Cell:03001111111 PTCL:xxx6235678
Pls donot forget to enter your city code in PTCL no. field)
Email Address :
Dispute Occured Where?
Name of ATM Bank :
City :
ATM ID \ Branch Name of ATM Bank (where transaction is Processed) :
City :
ATM ID -Branch Name of ATM Bank (where transaction is Processed) : -
 
Transaction Details :
Date of Transaction :
(dd/mm/yyyy e.g.:31/12/2006)
Time of Transaction :
(hh:mm e.g.: 23:59)
   
Amount Details :  
a) Transaction Amount :
b) Dispensed Amount
c) Undispensed / Retracted Amount (a-b)
0
Beneficiary Customer Details :
Name of Beneficiary Bank :
Title of Account :
Account Number :
- - - -
Account Number:
Remarks (if any)
 
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