Order Payment Decline Appeal
Use this form to appeal a declined payment for your recent order. Please provide accurate information to help us review your case quickly.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Order Number
*
Order Date
*
 -
Month
 -
Day
Year
Date
Payment Method Used
*
Credit or Debit Card
PayPal
Bank Transfer
Other
The Last 4 Digits of Your Card (if card was used)
What message did you see when your payment was declined?
*
Please explain why you believe your payment should be approved
*
Upload any supporting documents or screenshots
Upload a File
Drag and drop files here
Choose a file
Cancel
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Have you attempted to resolve this issue with your bank or payment provider?
*
Yes, I have contacted them
No, I have not contacted them
Submit Appeal
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