Partial ARC Refund – Blue Ribbon Travel

Refund Type*

Agent Name*

Agent Email*

IS THIS TICKET ON FILE?*

Company*

Passenger*

First Last

Void Auxiliary Segment (Provide specific info in Comments if needed)*

Airline Code*

Ticket Number*

Tax Breakdown Screen from Script (screen shot)*

Is this an International Refund?*

If Yes, is the YR tax Refundable or Non-Refundable

Is there a Waiver Code for this Refund?*

If Yes, Please Add Waiver Code

If there is Commission, is it Refunded?

Partial Refund Amount*

Penalty Amount (if applicable)

Amount of Refund less Penalty (if applicable)

Comments