Refund Request

Any refund request submitted may be subject to review at our discretion. Refund reviews will be conducted by the vending machine owner.
Refund requests may be submitted for up to but no later than 5 days past the stated date of loss.
Each item must be submitted on a single vending refund request form, no bundling of claims for multiple days will be honored at any of the vending refund locations.
All required fields of information on the vending refund request form must be completed or the refund will not be referred for review.
Barring unforeseen circumstances, refund decisions should be made available within 5 business days of receipt.

Please enter your contact information below in the event we need to contact you.

First Name ^*

Please enter your first name.

Last Name ^*

Please enter your last name.

Phone Number ^*

Please enter your phone number.

Email Address ^*

Please enter your email address.

Please enter the transaction specific information below.

Date ^*

Please select the date the transaction took place.

Location ^*

Please enter the location name. This is on the front of the machine.

Amount Lost ^*

Please enter the amount of money you lost in the transaction.

Machine Type ^*

Please select the type of vending machine.

Other Machine Type ^*

Please specify the type of vending machine.

Machine ID ^*

Please enter the Machine ID from the front of the vending machine.

Product Selection ^*

Please enter the name of the product or the number selection (example: A3)

Issue ^*

Please select the issue you experienced.

Describe the Issue ^*

Please describe the issue you experienced.

Digital Signature (Full Name) ^*

Enter your full name as your Digital Signature

By submitting this form, you agree to our Refund Policy, Terms and Conditions, and Privacy Policy.