Unauthorized Transaction Affidavit
Dispute charges, withdrawals, or electronic transfers on your bank account, debit card, or credit card that you did not make or authorize. Banks and card issuers use this sworn statement to process fraud disputes — including Regulation E electronic funds transfer disputes — and to issue provisional credit while they investigate.
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Download a blank PDF template to print and complete manually.
Download Blank TemplateUnauthorized Transaction Affidavit Affidavit — Frequently Asked Questions
How do I dispute an unauthorized charge on my bank account?
Notify your bank or card issuer as soon as you spot the charge, then complete its fraud dispute paperwork, which often includes a sworn unauthorized transaction affidavit. For debit card and electronic transfers, Regulation E generally requires the bank to investigate and, for disputes taking longer than ten business days, to issue provisional credit while it does.
How long do I have to report an unauthorized debit card transaction?
Report it immediately. Under federal Regulation E, your liability for a lost or stolen debit card is capped at $50 if you report within two business days and $500 within sixty days of your statement; after sixty days you may face unlimited liability. Credit card disputes are separately capped at $50 under the Fair Credit Billing Act.
How do I make a unauthorized transaction affidavit affidavit legally valid?
Fill in the unauthorized transaction affidavit affidavit, print it, and sign it in front of a Notary Public — do not sign beforehand. Bring a valid government-issued photo ID. Notaries are available at UPS Stores, banks, law offices, courthouses, and through online notarization services, and fees typically range from $2 to $25 per signature depending on your state.
Is this unauthorized transaction affidavit affidavit template free?
Yes. You can generate a completed unauthorized transaction affidavit affidavit PDF or download a blank printable template completely free, with no sign-up required. Your information is used only to generate the document and is not stored after the PDF is created.