Merchant Refund Request : STUDENT BUSINESS SERVICES : Texas State University

Please complete the following questionnaire so we can better assist you.

Please provide as much detail as possible to allow us to accurately process your requested refund.

Note: This form is for departments to request refunds only

Name of Requestor *

Requestor Email *

Enter your txstate.edu email address

Department Requesting Refund *

Indicate TouchNet Store Name *

Transaction/Order Number *

Transaction Date *

Payor Name *

Refund Amount *

Reason for refund *

If you happen to see this, do not fill this field.

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