Shri Mahalaxmi Co-Op Bank Ltd. Kolhapur providing Core Banking facility.

UNAUTHORIZED ELECTRONIC TRANSACTION: COMPLAINT REGISTRATION

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Select Channel used for Unauthorized Transaction*
Enter Transaction Time

My card was in my possession**
Acknowledgement"
I hereby declare that neither me nor my family member / representative performed / authorized the above transaction(s).
Further I hereby declare that I have not shared my login credentials / PIN / password / OTP/ CVV with any other person.
I declare that above given information is true and correct to the best of my knowledge.
I understand that I can be held liable for all charges incurred if dispute raised by me is found invalid.
I agree to pay the charges levied by the bank for the same including the cost incurred for investigation oI hereby authorize the Bank to deactivate the card on which the unauthorized transaction took place.