Model Mafia Reimbursement Form

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Please use this form to report any issues, concerns, or disputes related to the services provided by Model Mafia.

Your feedback is important to us, and it will help us improve our services and address any problems you may have encountered.

Please provide as much information as possible so that we can investigate the issue thoroughly and respond appropriately.
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Event/Production Name:* This field is required.
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Event Date: * This field is required.
Date
Month
Day
Year
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Your Role (Client/Production/Staff/Parent):* This field is required.
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Name* This field is required.
First Name
Last Name
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Your Title (if applicable)
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Company/Organization (if applicable):
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Email* This field is required.
example@example.com
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Phone Number* This field is required.
Please enter a valid phone number.
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Please provide a detailed description of the problem or dispute you are reporting. Include relevant dates, times, locations, and any individuals involved. Please be as specific as possible.* This field is required.
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If you have any supporting documents, such as photos, videos, contracts, or correspondence, that are relevant to the issue, please attach them here.* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Please let us know what outcome or resolution you would like to see regarding this issue. This will help us understand your expectations and work towards a satisfactory solution.* This field is required.
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If there were any witnesses to the issue you are reporting, please provide their names and contact information if known.
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Is there anything else you would like to add or any other relevant information you believe we should know about this issue?
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By submitting this dispute form, I confirm that the information provided is accurate to the best of my knowledge. I understand that Model Mafia will review the information provided and may contact me for further details or clarification if needed. I also consent to Model Mafia's investigation of this issue and accept that the final resolution may be subject to their findings.* This field is required.
Clear
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Date* This field is required.
Date
Month
Day
Year
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Reimbursement
Please Select
Direct placement
Membership
Day pass
Weekend pass
Uber/Taxi
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Approved amount
Should be Empty: