Refund and Credit Exception Form
Client / Account Name
Reseller Name
(Required)
Requested Amount
(Required)
Request Type
(Required)
Please Select
Refund
Account Credit
Date
(Required)
MM slash DD slash YYYY
Invoice / Transaction Reference
(Required)
Reason for Request
(Required)
Supporting Details & File Attachments
Drop files here or
Select files
Accepted file types: pdf, doc, docx, Max. file size: 25 MB.
Requester Name
(Required)
First
Last
Requester Email
(Required)
Please Review Before Submitting
Before requesting a refund or account credit, please review the 51Blocks
Terms and Conditions
, including the policies related to cancellations, refunds, and credits. All requests will be reviewed against these terms and remain subject to approval.
(Required)
I confirm that I have reviewed the 51Blocks Terms and Conditions before submitting this request.
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Submission Date
MM slash DD slash YYYY
Submitting this form does not guarantee that a refund or credit will be issued. Your request will be reviewed by our Billing and Leadership teams and is subject to approval. Once the review is complete or the team has an update, we will contact you using the email address provided.
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