If you received a letter in the mail stating that you may be eligible to have certain merchant-imposed fees refunded as the result of a returned non-sufficient funds item, please follow the instructions below to submit your request.
What you’ll need to get started:
- Access code from letter
- Social Security Number
- Account number
- Details of the check or ACH returned item
- check number (not applicable for ACH)
- who the item was made payable to
- amount of item
- date the item was returned
- Merchant fee amount
Please fill out the form below for each item that you are requesting to be refunded. If you have multiple items to be refunded, please fill out a separate form for each item.
Click to begin refund request