Customer Information
Name*
Surname*
Email*
Phone Number*
Identifying Document*
Clinent Code*
Incident Information
Type of fraud* Internet fraud (Account Takeover Phishing/Vishing/Smishing)Receiving a remittance using forged documentsTrader fraudStolen or Lost cardATM fraudIllegal card use onlineOther
Incident Date*
Description / Information
Additional Information
Information on Fraudulent Transaction
Transaction Code*
Amount*
Transaction From the counterVia WebBanking
Receiver Information of Fradulent Transaction
iban*
Address*
I am aware of the processing of my Personal Data by the Institution. I also understand that if I refer to Personal Data of third parties, I declare that I have taken care to inform them and have obtained their consent.
