Non-ARC/Airline Direct/Tour/Ship Refunds Agent Name* Select NameCharlieChrisDiJackieJamieJennaJoleenKariKatieKristinLindseyLisaMichelle Agent Email* Company* Invoice #* Passenger* First Last Void Auxiliary Segments?* Car Hotel Limo Rail No Provider Code/Name* Ticket/Confirmation Number* ETR/ Segment Refund Information* Full Refund Amount* Penalty Amount (if applicable) Amount of Refund less Penalty (if applicable) Comments