Need a Refund?

Please fill out the form below to request a refund for money that was lost in one of our vending machines.

What type of request is this? *

Repair

Refund

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Email Address *

Phone Number *

Machine Number (if Available)

Location of machine

Amount that was lost *

Product you attempted to buy

Comments

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Quick & Easy Refunds