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How to write your own Chargeback Reversal Agreement (Stronger)

You can create your own customized editable version of this contract document using IT/Software/Hardware Contract Pack. Follow these steps to get started.


Use the Chargeback Reversal Agreement if you have a customer who charged back a product or service inappropriately. You may need written permission from them to get the chargeback reversed.

This version is worded a bit stronger for cases where the customer violated your return policy and did a chargeback without working with you, etc. The intent is to get their statement in writing to take back to the credit card processor in case the customer is not being cooperative. It is always best to have written authorization up front on charges to avoid having to go back to the customer if problems occur as the credit card companies almost always side with the card holder, even if it is a fraudulent chargeback.
Document Length: 1 Page
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1. Get IT/Software/Hardware Contract Pack that includes this business contract document.

This Chargeback Reversal Agreement (Stronger) is included in editable Word format that can be customized in Word or by using the included Wizard software.

2. Download and install after ordering.

Once you have ordered and downloaded your IT/Software/Hardware Contract Pack you will have all the content you need to get started with your own formal declaration.

3. Customize the contract template with your own information.

You can customize the contract document as much as you need. You can also use the included Wizard software to automate merging in name/address data.

Chargeback Reversal Agreement (Stronger)

Writing the Chargeback Reversal Agreement (Stronger) document


Case Number:

Transaction Date:

Visa [ ] MasterCard [ ] Discover [ ] American Express [ ] Other:

Note: The merchant, "Company Name" has obtained sufficient tracking information for this transaction and will provide a rebuttal to the credit card issuer. The merchant reserves the right to request further investigation or refer the chargeback to the proper authority should a signature from the customer not be acquired. This transaction chargeback was reported in error.

I (the "Cardholder") agree to the reversal of the chargeback.

Print and Fax this form to:

Company Name Attention: Sales Dept - Fax Fax Number.

Print and mail this form to:

Company Name

City, State Postal Code

Important: Email, Adobe PDF, Email Faxes or other Electronic delivery of this form will NOT be accepted.

The complete Chargeback Reversal Agreement (Stronger) - with the actual formatting and layout - is available in this Contract Pack.
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Alternate documents are those which may be used instead of this document depending on your situation. Alternate documents may be better suited for different size projects, more specialized projects, variations on rights, etc.

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Create winning business proposals & contracts with minimal effort and cost. Proposal software, proposal templates, legal contracts and sample proposals.