How To Write A Credit Card Fraud Letter . Please let me know further steps to protect my account in the future. I have enclosed a copy of my date statement and circled the disputed charge. Sample Dispute Fraudulent Credit Card Transaction Form Template (With from www.pinterest.com I am requesting that the charge be removed, that any finance and other charges related to the fraudulent amount be credited, as well, and that i receive an accurate statement. Recently i received my credit card bill dated 22nd february 2014, the bill was amounted to 16,750. I would like to request that the (money charged be removed.