Travel Dispute

Name:

Account number:

(Please quote the card number used for this transaction)

Company:

Names of persons due to travel: Relationship to you:

1

2

3

4

5

6

Please note: the travel insurance premium won’t be reimbursed

and any refund claim should be referred to the insurance

company, broker or travel agent for advice.

Date of transaction:

Total amount paid on your Barclaycard:

Total amount paid by another method:

(cash/cheque/debit card)

Any amount paid by another credit card:

Less travel insurance premium:

Any other amount that you are claiming for additional expenses incurred:

No

Total amount you wish to claim:

Were any of the services received? Yes

If yes, the value of the service received:

Checklist for documentation required

1 Copy holiday invoice/confirmation (please note, without this

documentation we may not be able to evaluate your claim).

2 Letter referring you to your credit card company confirming

that the services/holiday will not be provided or any other

proof confirming the service will not be provided.

3 If any amount paid using another credit card, confirmation

that you have or have not approached the organisation and

their response.

4 Any other documentation you feel is relevant to support

your claim.

5 Copies of the original airline tickets including, e-ticket

or paper ticket.

If you are unable to return any of the relevant documentation

please indicate the reasons why in the box below.

Signature (main cardholder):

Date:

On occasions we may need to contact you by telephone, Monday to

Friday, about your query. Please provide your contact details below

(if appropriate).

8am – 12pm, telephone number:

12pm – 6pm, telephone number:

6pm – 9pm, telephone number:

Return completed form

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Please return your completed form, together with the required documents to our FREEPOST address: FREEPOST BARCLAYCARD DISPUTES.

Barclaycard is a trading name of Barclays Bank UK PLC. Barclays Bank UK PLC is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority (Financial Services Register number: 759676). Registered in England No. 9740322. Registered Office: 1 Churchill Place, London E14 5HP. Barclays Bank UK PLC adheres to The Standards of Lending Practice which are monitored and enforced by the LSB: www.lendingstandardsboard.org.uk

J404997 - 11/2017