Your First Name/Last Name

Address

Postal code/ CITY

[Name of your bank]

Address

Postal code/ City

Dated at [your city], on [specify the date].

Subject : Contestation of a payment for lost bank card

Dear Sir/Madam,

I hold a deposit account in your institution numbered [account number]. I lost my bank card on [date of loss]. I note that a card payment was subsequently made for an amount of [transaction amount]. In accordance with banking regulations, please re-credit this amount to me as soon as possible.

You will find attached a copy of the loss declaration.

Awaiting your response, please accept, Madam/Sir, my distinguished regards.

[Your signature]