Deposit Error Refund Application

All answers are mandatory unless otherwise noted.

Name*
First Last
Student/Staff/Guest Card Number*
Carleton Email*
Deposit Method*
Cash2Card Location*
If online, did you enter your email?*
- Yes
- No
If yes, did you receive a confirmation email?*
- Yes
- No
If yes, what was the reference number?*
Deposit Date*
MM slash DD slash YYYY
Deposit Time*

: Hours

Minutes

AM/PM
Deposit Amount ($)*
Amount in CAD$
Payment Method*
*
- I am aware that unless another Student/Staff/Guest Card number is provided in additional comments (below), funds will be deposited to the card provided above. I understand that staff of the Campus Card Office will investigate this request and funds will only be deposited if an error can be verified.
Additional Comments

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