Gift Card Claim Form

I hold a gift card that was purchased from Over Coffee LLC.  I would like to request a refund of the balance on said gift card due to the closing of Over Coffee LLC.

I understand that gift cards that were NOT PURCHASED and were given to organizations by OVER COFFEE LLC in lieu of advertising will NOT be refunded and have no VALUE as of the date of Over Coffee Closing.

Name:______________________________

Address:______________________________________

_____________________________________________

Gift Card #______________________________

Over Coffee LLC will issue you a refund of the residual value on the card after verification on the Radiant Systems Data Base.

Mail completed form along with gift card to

Over Coffee LLC

P.O. Box 8652

Surprise, AZ 85388

Please allow 2-3 weeks for processing.

Thank you for your business