Cookies must be enabled to use this form. Please submit the completed form or email us and we will contact you. Please mail all Telecom invoices for audit to: Recovery Refunds POB 466 Stratford, CT 06615-0466 for expedited service. Confidentiality is assured. You can also email us at Info @ RecoveryRefunds.com


Account Information Form

Company Name:
Contact Person:
Address:
City:
State:
Zip:
Main Phone Number:
Main Fax Number:
Contact person email address:
Comments:
If you have a telecom system in use, please place an x in the box for the type of system:
PBX CentrexEssx Key System Other (Identify)
Other:
Approximate monthly dollar amount of main local telephone bill excluding long distance and taxes $
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