Fraud/Unauthorized Transaction

Member Details

First Name

Last Name

Account Number

Account Type

Address

City

State

Zip

Phone Number

Email Address

Disputed Transactions

Zelle Payment ID (The Payment ID can be found in the transaction details in your Online Banking transaction history. Example: JIA0000eKd)

Transaction Amount

Transaction Post Date
mm/dd/yyyy

Transaction Type

Additional Transactions (optional)

Please include the Zelle Payment ID, transaction amount, transaction post date, and transaction type for EACH additional transaction.

Description of Incident

Summary

How did you notice the fraud?

Have you ever used Zelle before?

Yes
No

What devices do you use for Online Banking?

Does anyone else have access to your devices?

Yes
No

Does anyone else have access to your username and password?

Yes
No

Phishing Details

Have you provided your username and password to anyone as a result of a call or text that you received?

Yes
No

How did you come in contact with the recipient?

Which one of the following describes best who you believed you were conversing with?

Do you know the Recipient?

Yes
No

Have you transacted with the Recipient in the past?

Yes
No

Did you believe you were purchasing a good or service?

Yes
No

What was the reason you sent this payment? Please describe your intention for sending funds.

Were you told what could happen if you did not complete the transaction/ or what were you told?

Do you have any documentation to support your claim? If yes, attach files.

Select File(s) to Upload

When did you become aware of the fraud?
mm/dd/yyyy

Online Banking

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