Out-of-Sequence Checkout Exception Report Form
Report and document checkout transactions that occurred out of the normal sequence for compliance and review.
Reporter Name
*
First Name
Last Name
Reporter Email
*
example@example.com
Date and Time of Transaction
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Store / Location
*
Expected Checkout Sequence
*
Actual Checkout Sequence
*
Affected Customer or Order Reference
Exception Category
*
Please Select
System Error
Manual Override
Training Issue
Process Deviation
Equipment Failure
Other
Items Involved (list or describe)
Payment Status
*
Paid in Full
Pending Payment
Payment Failed
Refunded
Cause of the Exception
*
Please Select
Technical Issue
Human Error
Unclear Procedures
Customer Request
Other
Immediate Corrective Action Taken
*
Is Follow-Up Needed?
*
Yes
No
Additional Notes or Comments
Submit Report
Should be Empty: