Payment Reversal Request Form

This form consists of the following parts:

• Instructions
• Conditions
• Payment reversal request details
• Indemnity and waiver

Instructions

• This form must be completed in full and signed by the • You will receive an automated response with a reference number for
accountholder/mandated representative. the reversal request.
• The completed form must be emailed to • If this reference number is not received within 15 (fifteen) minutes,
fnbdigitalrecalls@fnb.co.za. please contact the bank on the number at the back of your card for
further assistance.

Conditions

• The bank does not guarantee a successful reversal and all reversals • If you have made a payment to an account listed below, please
are attempted on a best effort basis. contact the respective department/service provider directly for
further assistance.
• The bank must obtain authority from the recipient before a reversal
can be attempted. - Public recipient accounts such as Edgars, SARS and Telkom etc.
• The balance available in the recipient’s account must be equal to or - Investment accounts such as 32-day notice accounts etc.
exceed the amount paid/received.
- Vehicle Finance accounts.
• Reversals can only be attempted within 30 (thirty) calendar days
from the date of payment. - Credit Card account.

• A partial reversal/recovery of funds is not possible. - Any loan account such as Home Loan, Personal Loan etc.

• A Reversal fee is charged at R325.50 (inclusive of VAT) per - eBucks Payments made to another eBucks account.
transaction, this fee is non-refundable. • The terms and conditions for electronic payments is applicable and
• You will be charged a reversal fee irrespective of the result of the can be accessed on www.fnb.co.za, by selecting “Product Terms and
reversal attempt. Conditions” under the “About FNB + Legal” tab.

• There may be times where the Bank may not be able to affect a • Where you believe a fraudulent transaction has taken place, the
reversal request. In such instances, the bank may, in good faith, transaction must rather be reported to the bank’s fraud
provide you with further details to assist you in approaching the department. To proceed with reporting the transaction with the
recipient directly to recover your funds. You must complete and bank’s Fraud Department contact the bank immediately on 087
submit this form to fnbdigitalrecalls@fnb.co.za. Please note that 575 9444.
this request will be subject to a fee of R325.50 (inclusive of VAT) You will be required to submit the following
per transaction. information/documentation to the bank’s Fraud Department:
• Reversals will be attempted within 10 (ten) working days of the - Account number of the complainant
bank receiving this form.
- Suspected fraudulent account details
• Feedback on the reversal attempt will be provided after 10 (ten)
working days from the bank receiving this form. - SAPS case details
• Payment Reversals are not possible for: - An Affidavit
- Payments in excess of R5,000,000.00 (Five Million Rand) - Supporting documents (Proof of Payment)
- Payments using the Schedule Payments function.
- Payments using the Pay & Clear Now function.
In the above instances, the bank may, in good faith, provide you with
further details to assist you in approaching the recipient directly to
recover your funds. You must complete and submit this form to
fnbdigitalrecalls@fnb.co.za. Please note that this request will be
subject to a fee of R325.50 (inclusive of VAT) per transaction.

A division of FirstRand Bank Limited. An Authorised Financial Services and Credit Provider (NCRCP20). Reg. No. 1929/001225/06.
Payment Reversal Request Form
This form consists of the following parts:
• Instructions
• Conditions
• Payment reversal request details
• Indemnity and waiver

Payment reversal request details

From Account
Acc No. Holder Name
Contact Contact
Name Number
Email
Address Date

Payer account details (i.e. Account to which the reversal charge shall be debited).

Account Account Branch

Holder Name Number Code

Beneficiary account details (i.e. Account details of the recipient).

If there is insufficient space below, please complete additional spreadsheet with all details.

Account Number Branch Code Bank Amount Transaction Date Reason for Reversal

If we identify that the payment was a Pay & Clear Now or Schedule Payment that cannot be reversed, would
you like the bank to assist you further in the recovery of your funds at a cost of R325.50 (inclusive of VAT) Yes No
per transaction? (see Conditions)

Indemnity and Waiver

• You indemnify and hold the bank harmless against any loss, damage • You further authorise the bank to debit the nominated account/s for
or claim, (direct, indirect and consequential) which may be sustained charges associated with the reversal request and you indemnify the
as a result of the bank’s action in effecting the reversal of the bank against any loss, damage or claim (direct, indirect and
transaction/s and/or for instructing another bank to reverse these consequential) that the bank may suffer because you have not paid
transactions, which waiver and indemnity the bank accepts, acting the costs or fees associated with this reversal request.
upon the instruction referred to above and which purports to have
been issued or authorised by you. • By signing the below, you confirm that you have read and
understood the content of this document and you accept the
conditions and the indemnity and waiver herein.

Signature* Signature*
Who warrants Who warrants
that he/she is that he/she is
duly authorised duly authorised
thereto thereto

Name Name

Designation Designation

A division of FirstRand Bank Limited. An Authorised Financial Services and Credit Provider (NCRCP20). Reg. No. 1929/001225/06.