Partial Refund Request Form

• Please review your Terms and Conditions agreement for any provisions regarding the partial refund process.

• Determinations are typically made within (14) business days after the request submission. 

• You will recieve a notification or update regarding your request via email, including the final determination of whether the request has been approved or denied.

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Office Use Only **********************************

    ☐  Refund Accepted Date ____________

            ☐  Email Notification ____________

            ☐  Amount Refunded $ __________

                        ☐  Reversal        

                        ☐  Check by USPS: #________

            ☐  Refund Sent Date ____________

    ☐  Refund Declined Date _____________

            ☐  Email Notification _____________

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