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  3. CFPB's Regulation E
  4. APPENDIX A to Part 1005
  5. A-37
6-5357.118

A-37—Model Form for Error Resolution and Cancellation Disclosures (Short) (sections 1005.31(b)(2)(iv) and (b)(2)(vi))

You have a right to dispute errors in your transaction. If you think there is an error, contact us within 180 days at [insert telephone number] or [insert website]. You can also contact us for a written explanation of your rights.
You can cancel for a full refund within 30 minutes of payment, unless the funds have been picked up or deposited.
For questions or complaints about [insert name of remittance transfer provider], contact:
State Regulatory Agency
800-111-2222
www.stateregulatoryagency.gov
Consumer Financial Protection Bureau
855-411-2372
855-729-2372 (TTY/TDD)
www.consumerfinance.gov
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