Testing New Service Form - Coin Meter Support Portal

First Name

Last Name

Phone

For payment app refunds, use the phone number from your payment app account.

Email

For payment app refunds, use the email address from your payment app account.

Building Name/Location

Address

Address Line 1

City

State

Zip Code

Laundry Room

5 Digit CMC Number

Laundry Card Number

For refunds, please enter your laundry card number for faster processing.

Machine Type

Service Request Explanation

Refund Request Explanation