How do you want to receive the refund? Refund the balance to my credit cardMail it to my mailing addressMail it to a different addressContact me to schedule a pickup Do you know the name of the person who will be receiving this letter? Do you know the name of the person who will be receiving this letter? YesNo (write "To whom it may concern") Enter the recipient's name: Do you know the amount of the requested refund? Do you know the amount of the requested refund? YesNo What is the amount of the requested refund? $ Do you want to set a deadline for when you must receive the refund? Do you want to set a deadline for when you must receive the refund? YesNo Deadline: Where should the refund be mailed to? Street Address Address Line 2 City Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming State ZIP Code How should the recipient contact you to schedule a pickup? How should the recipient contact you to schedule a pickup? By MailBy PhoneBy Email What is your email address? Describe the item or services you are requesting a refund for: When did you originally purchase this item/service? Do you want to enter the reason for the refund at this time? Do you want to enter the reason for the refund at this time? YesNo, I'll do this later Explain why you are requesting a refund: What is your name? Enter the name of the person writing this letter. Is this letter being written by the person requesting the refund? Is this letter being written by the person requesting the refund? YesNo (I'm writing on their behalf) Enter the name of the person requesting the refund: Would you like to enter your contact information at this time? Would you like to enter your contact information at this time? YesNo, I'll do this later Street address: City, state, ZIP: Phone number: Do you want to enter the letter date now? Do you want to enter the letter date now? YesNo, I'll do this later Letter date: Do you want to electronically sign this letter? Do you want to electronically sign this letter? YesNo, I'll sign it later Signature: Clear Please draw your signature. Signature date: Next Save Save and finish later
