Credit Card Refund Request Form

(vending machines only)

This form is only for purchases made with a credit card at a vending machine.

If cash was used or if the purchase was made at a self-checkout market kiosk please call (877) 437-1373.

If your purchase was made at a market kiosk (not a vending machine), please call (877) 437-1373 to receive your refund. This form is to only be used for purchases made from vending machines.

Please go to https://www.cmsvend.com to request your refund.

If the product did not dispense your payment will be automatically refunded back to your account within 72 hours (if paid with a cashless option such as a credit card, debit card, ApplePay, or Google Wallet).

If for some reason the refund has not arrived after waiting 72 hours please select Yes and fill out this form.

Please know that refund form submissions made prior to waiting 72 hours will not be processed.

Thank you,

Imperial

Customer Information

Transaction Information

Transaction Date

Payment Method

Please provide the 4 digit device ID # found within the app on your phone if contactless pay was used (examples include but not limited to Apple Pay, Samsung Pay, Cash App, Google Play, etc.)