Payment Research

Please fill out this form to completion and submit. All requests are sent to the Payment Research Team.

Requestor Name*

Requestor E-Mail Address*

ASC ID*

ASC Name*

What is the request related to?*

Select

SR#

If submitting multiple SRs, enter the total number of SRs being submitted.

When was the SR paid?

Please describe the issue being submitted*

Upload Supporting Documents*

List of SR#s, screenshots, short tax form, etc.

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Send me a copy of my responses

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