If you believe you have been charged a surcharge incorrectly at an Allpoint ATM, please fill out this form and hit "submit" below. We will do our best to respond back to you within 24 hours.

Step 1.

Please enter the First 6 and Last 4 digits of Card Used during the transaction (No spaces) and PRESS ENTER.

First 6 digits of Card Used:

Last 4 digits of Card Used:


Step 2.

* All fields are required except Terminal ID.

Email:

Your Financial Institution:
 

Date of Transaction:
(mm/dd/yyyy)

Time of Transaction:

ATM Store Location Name:
 

ATM Street Address:
 

ATM City:
 

ATM State:

ATM Zip:

Terminal ID (found on ATM receipt):

Total Amount of Transaction (as shown on receipt):
$  

Was the fee amount included in the withdrawal amount as one line item on your statement?
Enter only Y or N

Comments: