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Please utilize this form Value Transfer Station Refund to request a Value Transfer (VTS) Refund for a Campus Cash transaction.

If you prefer to fill your form out offline, please download a PDF version.

Note: All fields are required.

University ID Number:
First Name:
Last Name:
Daytime Phone Number: ( ) -
Your Campus Address:
Email Address:
Amount of Funds Lost:
Value Transfer Station Location:
Date the problem was encountered:
Approximate time the problem was encountered:
Please describe the problem: