Refund Application

Instructions

Complete all fields of this form to ensure quick and accurate processing.
Either fax the form to (800) 314-9323 or mail it to:

YourScoreAndMore.com

Attention: Legal and Accounting Department

310 North Westlake Blvd., 200,
Thousand Oaks CA 91362

Please note: It takes up to 10 days from the time you send the application form for the team to receive it. Please call us back within 10 - 20 days after you have mailed in the form, so we can review and discuss your refund application.

If you have any questions, contact us at (800) 950-8040.

Refund Request Date:

First Name:

Last Name:

Email:

(Please use the same email address that you used when registering for the service)

Phone Number:

(Please use the same phone number that you used when registering for the service)

Order ID:

(You can find your Order ID in your welcome email)

Date of Registration:

Payment Method:

Bank:

Name on Card:

Card Type:

Last 4 Digits of Card #:

Copy of Bill - Please provide a printout or copy of a statement showing charges incurred

Amount Requested:

Reason for Refund - Choose 1:

Duplicate Payment
Fraud (Please provide a copy of the police report filed)
Service Never Worked

Yes
No

Signature

I declare under penalty of perjury that all the information contained in this form is true and accurate to the best of my knowledge.