Benefits Payment Card Dispute Form

If you have a transaction on your benefits payment card that you believe should be disputed, please fill out the form below. The transaction being disputed must be less than 60 days old. If the transaction date is more than 60 days old from today’s date, the transaction cannot be disputed as it falls outside of the dispute window per Visa regulations and as provided in the Cardholder Agreement.

***NOTE: You must attempt to resolve with the merchant directly (if possible) prior to submitting the dispute.***