Washin Coin Laundry Refunds
We are sorry to hear that you have had a concern with an item at our store.
Please complete all sections of this form to help us improve.
Store Location- Where are you?
Date of Concern *
MM
/
DD
/
YYYY
Equipment Type *
Equipment Number
Each Washer and Dryer has a number on the front.
Your answer
Description of Problem or Concern *
Your answer
Amount of Refund
Your answer
Name *
The Refund check will be sent to this name.
Your answer
Street Address *
Your answer
Apartment
Your answer
City *
Your answer
State
Your answer
ZIP *
Your answer
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