Electronic Payment - Fraud Dispute Form

If the claim you are filing is card related (Debit, Credit) and you need to report a problem, please follow these steps:

If the claim you are filing is account related, or ACH (routing and account number were used), please proceed with the instructions below.

To dispute, click the link to download the Written Statement of Unauthorized ACH Debit form, complete the necessary information, sign the form, and do one of the following:

Once we receive your completed form, Logix will credit your account within 3 business days.

Download PDF Form