Free Chargeback Request Template
A chargeback request asks your bank or card issuer to reverse a payment when goods or services were not received, were faulty or were not as described. Use our free UK template to submit a clear, well-documented chargeback claim.
Dispute ref: CB/2026/MZ-44193 · Account: 83729914 · Sort code: 04-00-04
I write to request a chargeback in respect of a disputed transaction on my debit card. Please treat this letter as formal notification of the dispute and as a formal complaint for the purposes of DISP 1 of the FCA Handbook. I require you to exercise the full chargeback rights available to you as issuer under the Mastercard Chargeback Guide.
Goods / services: Sony WH-1000XM5 wireless headphones, Order #SF-88821
Transaction date: 15 February 2026
Expected delivery / performance date: 22 February 2026
Amount charged: £245.00
Merchant / transaction reference: TXN-20260215-00443 / Order SF-88821
Card ending: ****3391 · Account: 83729914
I placed an order for Sony WH-1000XM5 wireless headphones on 15 February 2026 and paid £245. The tracking number provided by ShopFast Ltd has never updated from "label created". After three weeks the item has not been delivered and the company has ceased responding to all communications. The scheduled delivery date of 22 February 2026 has long passed.
This dispute is raised within the applicable scheme time limits (typically 120 days from the transaction date or, where relevant, from the date on which delivery was expected, for Visa and Mastercard).
— raise a chargeback under the applicable scheme rules;
— credit £245.00 to my account (and reverse any transaction-specific charges, fees or interest debited in connection with this transaction);
— pursue the merchant via the acquirer on the appropriate Reason Code, including any available re-presentment / pre-arbitration / arbitration stages.
I am happy to provide further documentation on request, including: order confirmations, delivery confirmations or their absence, correspondence with the merchant, screenshots of cancelled listings, terms and conditions, and any independent evidence relevant to the dispute.
— refer the matter to the Financial Ombudsman Service within 6 months of your final response, pursuant to DISP 2 and FSMA 2000 Part XVI;
— issue proceedings in the County Court for the sum claimed, together with statutory interest under section 69 of the County Courts Act 1984 and costs; and
— report the matter to the Financial Conduct Authority where there is evidence of systemic non-compliance.
All correspondence should be directed to Emma Wilson at the details above.
What Is a Chargeback Request?
A chargeback is a process by which your bank or card issuer reverses a debit or credit card payment on your behalf. It is available through the card scheme rules operated by Visa, Mastercard and American Express, rather than through statute.
Chargebacks can be requested when you have paid for goods or services that were not delivered, were significantly not as described, were defective, or when an unauthorised transaction has been made on your card. The process involves your bank contacting the merchant’s bank to recover the funds.
While chargeback is not a statutory right under UK law like Section 75 of the Consumer Credit Act 1974, it provides an important additional route for recovering money in Britain. It is available for both debit and credit card transactions in the United Kingdom and can apply to lower-value purchases that fall outside Section 75 protection.
What's Covered in This Template
Our chargeback request template helps you present a strong case to your bank.
Your Details
Full name, address, account number and the last four digits of the card used for the transaction.
Transaction Details
Date, amount, merchant name and reference number of the transaction you are disputing.
Reason for Chargeback
Clear categorisation of the reason: non-delivery, defective goods, not as described or unauthorised transaction.
Timeline of Events
Chronological account of the purchase, any delivery attempts, complaints to the merchant and their responses.
Merchant Contact Attempts
Evidence that you attempted to resolve the issue directly with the merchant before requesting a chargeback.
Supporting Evidence
List of documents attached to support your claim, such as emails, photos, receipts and tracking information.
Amount Claimed
The specific amount you are requesting to be reversed, whether full or partial.
Declaration
Statement confirming the accuracy of the information provided and that the dispute is genuine.
Bank Contact Details
Pre-formatted address block for your bank’s disputes or chargeback department.
Reference Checklist
A checklist of supporting documents to include with your request to strengthen your case.
How to Submit a Chargeback Request
Follow these steps to maximise your chances of a successful chargeback.
- 1
Try to Resolve with the Merchant
Contact the merchant first to request a refund. Keep records of all communication. Banks require evidence that you attempted resolution before requesting a chargeback.
- 2
Gather Your Evidence
Collect all relevant documents including receipts, order confirmations, emails, photos of defective goods and delivery tracking information.
- 3
Complete the Request Letter
Fill in your details, the transaction information and a clear explanation of why you are disputing the charge.
- 4
Submit to Your Bank
Send the completed letter and supporting evidence to your bank’s disputes team. Most banks accept submissions by post, email or through online banking.
- 5
Follow Up
Note the time limits for your card scheme and follow up with your bank if you do not receive a response within the expected timeframe.
Legal Considerations
Chargebacks operate under card scheme rules rather than statute, but interact with UK consumer protection law.
This template is for informational purposes only and does not constitute legal advice. Consult a qualified solicitor for advice specific to your situation.
Reviewed for England & Wales law
Card Scheme Rules
Chargeback rights are governed by the rules of the card scheme (Visa, Mastercard, Amex) rather than UK legislation. Each scheme has its own reason codes, time limits and evidence requirements. Visa and Mastercard generally allow British cardholders to request chargebacks within 120 days of the transaction or expected delivery date.
Difference from Section 75
Section 75 of the UK Consumer Credit Act 1974 makes the British credit card issuer jointly liable with the merchant for breaches of contract or misrepresentation on purchases between £100 and £30,000. Chargeback in England and Wales has no minimum threshold and applies to debit cards, but is a voluntary scheme rather than a statutory right.
Payment Services Regulations
For unauthorised transactions in the United Kingdom, the UK Payment Services Regulations 2017 provide statutory protection. Your British bank must refund an unauthorised payment immediately unless it suspects fraud. This is separate from the chargeback process under English law.
Merchant Defence
The merchant can challenge a UK chargeback through representment, providing evidence that the transaction was legitimate and the goods or services were delivered as described. If the merchant successfully defends in the British card scheme process, the chargeback may be reversed.
Frequently Asked Questions
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