KickBack Manual Points Submission

KickBack Manual Points Issue

Form for managers to send in manual points issued requests.

Store Number:(Required)

Customer Name:(Required)

First Last

Phone Number:(Required)

Enter customers phone number.

KickBack Card Number:(Required)

You must enter a valid Kickback card number.

Reason for Manual Issue:(Required)

Upload File:(Required)

Drop files here or

Max. file size: 50 MB.

A scanned copy of the transaction receipt is required.