Credit Memo Request Form

Credit Memo Request Form

please complete the form below to request credit memos
Brand
Promotion Type
For example: Buy 2 Get 1 Free
Date of Promotion

MonthDayYear
Date
For CCell Tier Deal or promotions ranging more than one day please enter start date and end date below
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Requested By:
Store representative
Store Name:
Please provide DBA name
Promotion Approval Number (PAN):
This number can be found in the approval email from your initial request
Requested Credit Amount $
Amount verified from credit report (uploaded below)
Upload Sales Report

Browse Files
Accepted files: doc, docx, xls, xlsx, csv, txt, rtf Cancelof
Notes;
Please include any relevant details about your request
Email (for confirmation):
example@example.com
Alternate Email (for confirmation):
Upload Credit Report
Accepted file types: doc, docx, xls, xlsx, csv, txt, rtf Cancelof
Should be Empty: