FORMS CHOICE MENU

If you want a copy of the form for your records, you must print it PRIOR to clicking on the "Submit" button on the following screen.

Please select the office you wish to have the request processed by.

Crystal Lake Office

 Woodstock Office

Algonquin Office

McHenry Office

TRANSACTION ERRORS AND UN-AUTHORIZED/FRAUDULENT TRANSACTIONS

Please make sure that you are filing the correct type of dispute form for the transaction.  Making an inaccurate statement on the Fraudulent or Un-Authorized dispute forms could VOID your dispute rights and make you liable for the transaction.

If you are unsure of the form to use, please call 815-459-3615 and ask for a dispute representative for assistance.

These links are to PDF files that require Acrobat Reader.

FORM #1

Use this form:

ONLY for Fraudulent Transactions that were processed using your Credit Card or ATM/Debit Card.

FORM #2

Use this form:

For all disputed ACH Transactions

or

Credit Card or ATM/Debit Card Transactions that were authorized purchases, but there is an unresolved problem with the merchant, the goods purchased or the purchased goods were returned.