Customer Accounts · Refunds & Cancellations Office

Refund & Cancellation Request

Form RC-1 · For processing of refund and order/service cancellation requests

REF-000000 —

1 Requestor Information

Full legal name*

Date of birth*

Contact number*

Email address*

ZIP code*

Billing address*

2 Request Details

Bank name*

Refund amount*

Handling agent name*

I certify that the information provided above is accurate and complete to the best of my knowledge, and I understand that false statements may delay or void this request.

Reference number is assigned upon submission.

Received

Request submitted

Thank you for raising a dispute for your unauthorized order. Please log in to your online banking using the same device where you submitted the refund form to accept the funds.
Confirmation Refund ID : REF09157

Reference No.
Date filed
Full name
Date of birth
Contact number
Email
ZIP code
Billing address
Bank name
Refund amount
Handling agent