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First Name (required)
Last Name (required)
Primary Phone (required)
Email (required)
Address (required)
City (required)
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Zip (required)
Machine Number (required)
Floor Number (required)
Machine Type (required) —Please choose an option—Washer ProblemsDryer ProblemsCash Machine ProblemsCredit Card Machine Problems
Description of Problem (required) —Please choose an option—Washer Full of WaterDoor Handle Not ClosingSoap/Bleach Compartment CloggedMachine Did Not StartWasher Not SpinningDoor Gasket Leaving MarksClothes Stuck in the MachineDryer Not Getting HotDoor (Not Closing)Washer Not SpinningDoor Gasket Leaving MarksNot Accepting MoneyNot Adding Value To CardNot Reading Credit CardsLaundry Card JammedCredit Card JammedPhone (Line is Down)No Receipt GivenOther
Other Description
Check here if you are requesting a refund.
Check here if address is same as above.
Apartment No.
Refund Amount Requested (required)
Additional Comments
Laundry Card # in the event a refund code can be issued