Account Email Change Dispute Form
Use this form to report and dispute an unauthorized, incorrect, or disputed email address change on your account. All information provided will assist in resolving your account email change dispute.
Full Name
*
First Name
Last Name
Preferred Contact Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Account Username (or Reference ID)
*
Current (Correct) Email Address on Account
*
example@example.com
Disputed Email Address (the one changed to)
*
example@example.com
Date the Email Change Was First Noticed
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Issue
*
Unauthorized email change
Incorrect email entered
Email change made in error
Other (please specify)
Please describe the circumstances and details of the email change dispute
*
Describe the resolution you are requesting
*
Submit Dispute
Should be Empty: