JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
RagingAzn628's Avalon ASIC Chips Refund
Sign in to Google
to save your progress.
Learn more
* Indicates required question
BitcoinTalk Username:
*
Your answer
BTC Refund Address
*
*Please PM John.K your refund address to confirm that you are the right owner*
Your answer
Originally Txid for BTC transaction:
*
Sending TX ID (proof of payment)
Your answer
How many chips in total did you purchase?
*
From group buy or from other GB members.
Your answer
Did you buy chips from any other members in the GB?
*
If yes, write the person's username in "Other:". Please provide Txid as well.
No
Other:
Did you sell chips to anyone else?
*
If yes, write the person's username in "Other:". Please provide Txid as well.
No
Other:
Amount being refunded (in BTC):
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
