Credit Card Change/Refund Request
This form is to be submitted to either request a refund or to have your Credit Card information changed. Once a refund is requested we will review the account. We will respond in writing the decision.
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Email *
Child(ren) Name(Please add all the children's names One form per family) This is to make sure it is applied to each child properly *
Refund For *
Reason for Refund
Credit Card Change Request
Please Provide Information on your new card. IF not asking for credit card update, type N/A)
New Card Number and CVC Code on the back. Example: 444-4444-4444   CVC 000 *
Expiration Date on card OR Dates of Service for Refund *
Name on Card and Billing Address (N/A if not for CC Change) *
Authorization
I authorize T.A.P.S., Inc to charge my credit card for agreed upon Reoccurring  weekly fees, Child Care Services, Fees and Balances.  I agree that my card information will be saved for future transaction on my account. I agree that all the information is true and accurate and I am the authorized owner/user of this card and assume all financial responsibilities.  I agree it may take 3-5 Business Days at minimum if my refund is approved as a payback and not a credit. I understanding I may incur late fees if this form is received after the date for payment is due.
Do you Authorize the use of this card including debits and credits and validate the accuracy of the information? *
Name of Person Filling out Form *
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