Помогите правильно перевести текст с английского. Онлайн переводчики не подходят.

Прошу не предлагать онлайн переводчики на подобие google translate, предоставленная часть текста является официальным документом и нужен корректный перевод, а не его смысл.

Текст:

I am disputing the above charge due to the following reason (check only one reason):

_____ I have not, nor has anyone authorized
by me engaged in this transaction.
My card was lost on (date): __________
My card was stolen on (date): __________

_____I have not authorized or participated in this transaction in any way. My card has not been out of my possession.

_____I have participated in one transaction at the merchant location, but NOT the transaction listed. I, or someone authorized by me was in possession and control of all cards at the time of the
transaction. The authorized transaction amount was $ ___________ on (date)__________.

_____I am disputing the listed ATM withdrawal. I have explained the details below.

Please provide specific details below, on back or a separate sheet of paper.