Application for Credit/Refund Form

To proceed with the credit/refund application, please follow the following steps:

• Fill out the form below with the required details.

• Our team may reach out to you via email if further clarification is required.

Sign in to Google to save your progress. Learn more
Application date: *
MM
/
DD
/
YYYY
CONTACT DETAILS:
Username: 
*
Registered Email: *
Registered Mobile No: *
CREDIT/REFUND DETAILS:

*
Required
Please indicate the reasons for refund: *
Required
Please indicate how the wallet was previously top-up:  Please select one only
* Refund is processed back using the original top-up method.
*
Please indicate the refundable amount:
Please confirm if you wish to proceed with the closure of your account.
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report