Debit Card Fraud

Please complete and submit this form for all SECU debit card fraud claims. For credit card fraud claims, please call 800-344-6501 to submit your claim. Fields marked with an asterisk (*) are required.

Full Name*

First Name

Last Name

Member Number*

Phone*

Email*

Confirm Email *

Card Status*

To process your claim, your card must be closed. Please call 1-800-879-7328 and request the card be closed immediately to avoid further exposure to fraudulent transactions and to order a new card.

In the event you do not call to close your card, your card will be closed prior to processing your claim. A new card will not be ordered.

How many unauthorized transactions were there?*

You can enter up to 10 items per form submission.

Fraudulent/Unauthorized Transaction #1

Date*

Merchant Name*

Amount* $

Fraudulent/Unauthorized Transaction #2

Date*

Merchant Name*

Amount* $

Fraudulent/Unauthorized Transaction #3

Date*

Merchant Name*

Amount* $

Fraudulent/Unauthorized Transaction #4

Date*

Merchant Name*

Amount* $

Fraudulent/Unauthorized Transaction #5

Date*

Merchant Name*

Amount* $

Fraudulent/Unauthorized Transaction #6

Date*

Merchant Name*

Amount* $

Fraudulent/Unauthorized Transaction #7

Date*

Merchant Name*

Amount* $

Fraudulent/Unauthorized Transaction #8

Date*

Merchant Name*

Amount* $

Fraudulent/Unauthorized Transaction #9

Date*

Merchant Name*

Amount* $

Fraudulent/Unauthorized Transaction #10

Date*

Merchant Name*

Amount* $

Have you ever done business with the merchant(s) above?*

Yes No Both - I will explain below.

Additional Comments

I confirm the information contained in this document is truthful. I acknowledge SECU may release the information contained herein to law enforcement officials for investigative purposes.*

I agree.

Pending an investigation, credits will be issued within ten (10) business days of receipt of this form.