PA RTN E R S H I P CARD
Cardholder Card Number: Name:
Please complete details of the transaction. Amount(s): Merchant Name: Transaction Date : Please tick the appropriate item(s) I confirm neither I, nor any additional cardholder assigned to my account, authorised or participated in the above transaction(s). I confirm neither I, nor any additional cardholder assigned to my account, recognises the transaction(s) and every effort has been made to identify the transaction with the issuer and / or the merchant. I have cancelled the continuous authority with the merchant on (date) [ being charged. (Please enclose a copy of the cancellation letter)
] but my account is still
I did authorise this item but have not received the goods or services. I have contacted, or attempted to contact, the merchant without success. (Please enclose a copy of your sales invoice or receipt - if this is not available, please state why). I only authorised one transaction from this merchant for [£ ] but not the item(s) for [£ (Please enclose a copy of the sales voucher for the transaction you authorised).
The amount I agreed differs from the amount charged. (Please enclose a copy of your sales voucher. Please note: some hotel and car rental agreements are subject to a Final Audit Clause). The item was paid for by other means. I paid by [ ] but the transaction appears on my Partnership Card statement. (Please enclose a copy of the front and back of the paid cheque or a copy of your cash receipt or copy sales voucher/statement from other credit card). Signed : (Primary Cardholder)
Signed : (Additional Cardholder)
Please note: The fee for a Copy Voucher is £5.00. This fee will only be charged if the item proves to be valid and the details shown on your statement are correct. Please post this form to: John Lewis Financial Services Limited, PO Box 5137, Coventry CV3 9EP John Lewis Financial Services Limited (a subsidiary of HSBC Bank plc), registered in England under Company Number 4645530. Registered office: 8 Canada Square, London E14 5HQ. Authorised and regulated by the Financial Conduct Authority under the Financial Services and Markets Act 2000 (Financial Services Register no 715060), and under the Payment Services Regulations 2009 (Payment Services Register no 542750) for the provision of payment services. ‘Partnership Card’, ‘John Lewis Finance’ and other terms including ‘John Lewis’ are John Lewis Partnership brands and John Lewis Financial Services Limited uses them under licence from the John Lewis Partnership.