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REFUND APPLICATION

Refund requests must be made within ONE WEEK of the transaction error.

Today’s Date: 2/26/2020

Date of Error:

Customer Contact Information

Name: guest guest

ID#: 0

Carroll E-mail:

Phone #:

Describe Problem:

Loss in Carroll Ca$h $

Loss in Coin/Currency $

Type of Service:

Building Location:

Specific Locations (Machine #/description):

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