Request a Vending Machine Refund

Please use this form to request a vending machine refund. A detailed explanation is required for us to review your case. All requests must be submitted within 30 days of the incident. Thank you.

Your Contact Information

Your Name* Your Email* Your Phone* Your Street Address* Your City* Your State* Your Zipcode*

Vending Machine Information

Company/Business Name* (if requesting on behalf of Scioto Vending client) Street Address of Vending Machine* City* State* Zipcode* Machine Location Description* (example: 2nd floor / "near elevator") Machine Type* Selection #/Flavor*

Refund Information

Date of Occurrence*

Payment Type*

Card Last 4 Digits (Required)*

Refund Amount Requested* Description of Refund Request

By submitting this form you certify that this request for refund is valid and truthful.