Debit Card Dispute

To dispute a debit card charge that has posted to your account either from a merchant or an ATM transaction, please read, complete and sign this form and click the submit button within 10 business days of the transaction in question.

You may receive a conditional credit for the disputed dollar amount. All disputes must be received within 60 days of you receiving the periodic statement on which the transaction appears. If we receive the form later than 60 days there may be no recourse. If we need more time to investigate, we may take up to 45 days.

For questions, please contact us or call (605) 342-7776.

Name *
Card Type
Was your card
I’ve attempted in good faith to resolve this dispute with the merchant. (If Yes, include details below)
CATEGORY: Check ONE category below that best describes your dispute for the transactions listed. Please note: Complete a separate form for each transaction if more than one category applies.
Was the item billed monthly
ATM Dispute
If one of the below categories is selected, you must include a detailed description of the merchandise or service you purchased in the space provided.
Disputed Transaction, Please include Transaction Date, Merchant or ATM Location, Amount ($), Merchant Contact Date, and Merchant Response for each disputed transaction.