Refund Request Form

1
Please review our refund policy to determine if a refund is due. View our refund policy on our website at View Refund Policy Here. If a refund is due please submit a refund request form within 14 days of cancellation. If you are unsure about a possible refund, please contact our office at 334-781-5597 or email at cancel@befouryougo.com.
2
Today's Date* This field is required.
Date
Month
Day
Year
05
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
Hour
15
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
Minutes
3
Name* This field is required.
First Name
Last Name
4
Last 4 of Social* This field is required.
5
E-mail* This field is required.
example@example.com
6
Reason for Refund* This field is required.
7
Service Plan* This field is required.
Tier 1, Tier 2, Tier 3, Customized Plan( This includes Discounted Plans, Special Promotions, F&F etc.)
8
Have you reviewed our refund policy? * This field is required.
YESNO
9
Requested Refund Amount* This field is required.
10
Additional NotesList any pertinent information or changes we should know. Do NOT enter any sensitive infomation.
Huge
Large
Normal
Small
Ok
Ok
11
Type a question
If eligible for a refund, I agree to receive my refund via the original payment method.
12
Signature* This field is required.
Clear
13
How do you rate our service? * This field is required.
1
2
3
4
5
Should be Empty: