JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
[US] Refund Request - Travel Voucher
Agency’s Email Address
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Passenger Email Address
*
Your answer
Agency’s IATA Number (1234567-8)
*
Your answer
Ticket Number (123-1234567890)
*
Your answer
If the above ticket has a conjunction, please enter the last 4 digits of the original ticket
Your answer
Passenger First Name
*
Your answer
Passenger Last Name
*
Your answer
Passenger ID (FOID)
*
Your answer
Country were the ticket was issued:
*
COLOMBIA
UNITED STATES
Other:
Required
By sending this form I confirm that the passenger agrees to leave the ticket without effect for future flights and cannot request a chargeback
*
I Agree
Required
Would you like to submit a new ticket?
Yes
No
Clear selection
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of LATAM Airlines.
Report Abuse
Forms
