ONLINE ORDER REFUND SUBMISSION
**This form is for ONLINE ORDERS ONLY**
RESTAURANT REQUIRING REFUND
*
LG02 MISSION VALLEY
LG03 BRESSI RANCH
LG04 HILLCREST
LG05 EASTLAKE
LG06 LIBERTY STATION
LG07 IRVINE SPECTRUM
LG08 LAKE FOREST
LG09 SCRIPPS RANCH
LG10 WESTPARK
LG11 POWAY
LG12 HB BELLA TERRA
LG13 RANCHO SAN DIEGO
LG14 ALISO VIEJO
LG15 FLOWER MOUND
LG16 LA COSTA
LG17 EL CAMINO REAL
LG18 CLAIREMONT
LG19 COLLEYVILLE
LG20 SOUTHLAKE
LG21 LA CANADA
LG22 DANA POINT
LG23 TEMECULA
LG24 EASTVALE
LG25 VENTURA
LG26 RANCHO CUCAMONGA
LG27 CERRITOS
LG28 DEL AMO
LG29 RICHARDSON
LG30 ALLIANCE
LG31 MIRA MESA
LG32 OXNARD
LG33 MARKET PLACE
LG34 PACIFIC HIGHLANDS
LG35 UC IRVINE
LG36 MANSFIELD
LG37 SHERMAN OAKS
LG38 HB NEWLAND CENTER
LG39 SANTA MONICA
LG40 ENCINITAS
LG41 RANCHO SANTA MARGARITA
LG42 SANTA BARBARA
LG43 CLEARFORK
LG44 CULVER CITY
LG46 PALM DESERT
LG47 DALLAS - THE HILL
LG48 REDLANDS
LG50 CHINO HILLS
LG53 ANAHEIM
LG54 PASEO DEL SUR
LG55 LAKEWOOD
LG57 MILLENIA
LG61 SANTEE
LG63 MENIFEE
Other
SUBMITTER NAME
*
First Name
Last Name
RESTAURANT EMAIL
*
example@example.com
GUEST NAME
*
First Name
Last Name
GUEST PHONE NUMBER
*
-
Area Code
Phone Number
GUEST EMAIL
*
example@example.com
DATE OF ORDER
*
-
Month
-
Day
Year
Date
FULL AMOUNT ORDERED
*
AMOUNT TO BE REFUNDED
*
REASON FOR REFUND
*
WAS THE ORDER VOIDED OR COMPED IN THE POS?
*
Yes
No
WHY WAS THE ORDER NOT VOIDED IN THE POS?
*
ORDER NUMBER
*
This number can be found on the guest's email confirmation. Refunds cannot be processed without this number.
UPLOAD RECEIPT
*
Browse Files
Cancel
of
OTHER IMPACTED RESTAURANTS
ADDITIONAL INFORMATION
If applicable
Submit
Should be Empty: