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Get NIH Federal Credit Union Notification Of Disputed Transaction 2010-2024

R, and you have been unable to resolve the situation with the merchant, please complete and sign a copy of this form using blue or black ink. This form must be received at NIH Federal Credit Union within 60 days of the closing date as printed on your statement. Please include a copy of your statement underlining the disputed transaction. Transaction Amount: $ Transaction Date: Disputed Amount: $ Reference #: Merchant’s Name: I contacted the merchant on in an attempt to resolve this disput.

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