Rideshare Authorization Hold Dispute Form
Use this form to dispute a temporary authorization hold related to your rideshare trip. Please provide accurate trip and payment details to help us resolve your issue efficiently.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Trip Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Pickup Location
*
Dropoff Location
Trip Reference or Booking ID (if available)
Last 4 digits of the card used for payment
*
Amount of the authorization hold (if known)
Describe the issue with the authorization hold
*
Submit Dispute
Should be Empty: