The purpose of a dispute cancellation form is to allow customers to request to withdraw their payment dispute, and this completed form will then be used as supporting evidence to close a dispute in the merchant's favour. To download this form, please click on the attachment below.

If a customer requests to withdraw their dispute, the merchant will need to obtain the dispute cancellation form (see below) from Curlec and pass it on to their customer. The account holder/card holder will need to complete the form and send a scanned copy to the merchant, who will then pass it on to Curlec to submit to the issuing bank.

Thorough checks are performed by the banks so customers will need to ensure the following:

  • The first 6 and the last 4 digits of the card number is for the card used for the disputed transaction.
  • Card Holder Information matches the bank's record.
  • Customer's signature matches the bank's record. (Note: The signature can be physical or electronic. However, an electronic signature is accepted only if it is a scanned handwritten signature. A typed name in electronic form will not be accepted.)

Types of electronic signatures
Accepted by bank?
Scanned handwritten signature


Typed name signature