Refund Request Form

A refund request form is used to process product refunds online.

Questions for Refund Request Form

1.

Name

The answer should be a text input.
2.

Email Address

The answer should be a email input.
3.

Phone number

The answer should be a phone number.
4.

Request Date

The answer should be a date input.
5.

Reason for Refund

The answer should be a text input.
6.

Product Name

The answer should be a text input.
7.

Product ID

The answer should be a text input.
8.

When did you buy the product?

The answer should be a date input.
9.

Do you have the invoice?

The answer should be a single choice:
  1. Yes
  2. No
10.

Have you read the refund policy?

The answer should be a single choice:
  1. Yes
  2. No
11.

Based on the refund policy, are you eligible for a refund?

The answer should be a single choice:
  1. Yes
  2. No
12.

Requested Amount

The answer should be a text input.
13.

Comments

The answer should be a text input.
14.

Signature

The answer should be a signature.
15.

Date

The answer should be a date input.

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