ILLUSTRATIVE SAMPLE. Case SAMPLE-01 is invented. Every name, order number, amount, address fragment and
timestamp below was written for this example from public platform documentation. No real merchant,
customer, carrier or bank record appears here. This file is not a template you can submit; it shows
the shape of the document a dispute evidence desk case produces.
Evidence packet, prepared for merchant submission
Dispute SAMPLE-01 Order 10482
Reason
Fraudulent transaction
Disputed amount
$340.00 USD
Order date
Aug 24, 2026
Response due
Sep 19, 2026
Merchant
Northerly Supply Co. (invented)
Prepared
Sep 7, 2026, all times ET
Index of exhibits
Fourteen pages. Set in black and white, with no information carried by color.
No.
Exhibit
Pages
Status
01
Order record. Line items, discounts, timestamps
1–2
Attached
02
Gateway transaction detail. AVS full match, CVV match
3
Attached
03
3D Secure result. Not requested at checkout
none
Missing
04
Carrier history and proof of delivery. Delivery photo, no signature on file
4–6
Partial
05
Customer message thread. Four messages, unedited
7–9
Attached
06
Refund and store credit history. One partial refund, $60.00
10
Attached
07
Policy as posted on the order date, with the checkout acceptance record
11–14
Attached
Exhibit 01: order record
Field
Value
Order number
10482
Placed
Aug 24, 2026, 9:12 PM ET
Customer account created
Mar 2, 2025 (17 months before the order)
Prior orders on the same card
3, most recent Jun 11, 2026
Items
Coastal Shell Jacket, size M, $280.00. Ridge Beanie, $60.00.
Subtotal / shipping / total
$340.00 / $0.00 / $340.00
Billing and shipping address
Same street address, Denver CO. Full address is on page 1 of the packet.
Exhibit 02: gateway transaction detail
Check
Result
Address verification (AVS)
Full match, street and postal code
Card security code (CVV)
Match
3D Secure
Not requested at checkout, no result exists
Customer IP at checkout
Denver CO, same metro as the shipping address
Device
Same browser fingerprint as the Jun 11, 2026 order
Exhibit 04: carrier history and proof of delivery
Scan
Timestamp
Label purchased
Aug 25, 2026, 10:04 AM ET
Picked up
Aug 25, 2026, 5:47 PM ET
In transit, regional facility
Aug 27, 2026, 3:12 AM ET
Delivered, photo on file
Aug 28, 2026, 2:41 PM ET
Signature
Not purchased with the label, none exists
Exhibit 05: customer message thread, unedited
Aug 24, 2026, 9:19 PM ET, customer to supportOrder confirmation received. Can I still add a second beanie to this order?
Aug 25, 2026, 9:31 AM ET, support to customerThe order was already picked, so we cannot add to it. Happy to ship a second beanie separately if you want.
Aug 29, 2026, 8:07 AM ET, customer to supportThe package arrived yesterday. The jacket fits but the beanie is smaller than I expected. What are my options?
Sep 2, 2026, 11:22 AM ET, support to customerRefunded the beanie, $60.00, back to the original card. Keep it, no need to send it back.
Exhibit 07: policy as posted on the order date
Item
Record
Returns policy version in force
Published Jul 9, 2026, unchanged through Sep 7, 2026
Return window stated
30 days from delivery
Checkout acceptance record
Terms accepted Aug 24, 2026, 9:12 PM ET, same session as the order
Evidence form, field by field
Field 02, product description
Order 10482 was placed on Aug 24, 2026 at 9:12 PM ET. Two items: Coastal Shell Jacket, size M, $280.00, and Ridge Beanie, $60.00. Subtotal $340.00 with free shipping. The billing address matched the card on file, returning an AVS full match, and the security code matched.
Field 05, shipping documentation
The label was purchased Aug 25, 2026 at 10:04 AM ET to the shipping address on the order. Carrier scans show pickup Aug 25, an in-transit scan Aug 27, and delivery Aug 28 at 2:41 PM ET with a delivery photo, attached as Exhibit 04. Signature on delivery was not purchased with the label, so no signature exists.
Field 08, additional evidence
The cardholder emailed support on Aug 29 at 8:07 AM ET confirming the package arrived and asking about sizing. The full four-message thread is Exhibit 05, pages 7 to 9, unedited. A partial refund of $60.00 was issued Sep 2 and appears as Exhibit 06. The returns policy in force on the order date is Exhibit 07, with the checkout record showing acceptance at 9:12 PM ET on Aug 24.
Gap note, page 1 of 1
Missing record
Why it is missing
Where it should have been captured
3D Secure result
The checkout does not request 3D Secure on card payments, so the gateway has no result to hand over.
At checkout. Decide whether to request it, and above what order value.
Delivery signature
The carrier delivered with a photo and no signature.
When the shipping label is bought. Signature on delivery is an option chosen at label creation.