Tracking Form: Return of Funds
Mobile Number:
Email: Email Status No
Cynthia & Legal Team:
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Pending Review
Eligible
Not Eligible
Fund Return Eligibility
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Notes:
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OFFICE USE: Sherri G and Stacy D
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Reviewed by Finance Dept
Recipient Status
Fund Information
Conformation Dates
Device Status
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Active
Banned
Canceled
Membership Status
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NO
YES
VIP Status Forfeited
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No Changed
VIP Status Removed
VIP Status Updated
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Limited Reinstatement Required
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Limited Reinstatement Start Date
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Limited Reinstatement Ended
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Request Received
Under Review
Approved
Awaiting Bank Verification
Ready for Wire
Wire Initiated
Return Completed
Closed
Fund Return Status
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Fund Return Request Date
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Select...
HHS
QHR Replicator
HHS & QHR
Other
Fund Return Device Type
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Total Contributed Amount
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Fund Return Amount Requested
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Adjusted Return Amount
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OP Fund Return Invoice #
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NO
YES
Confirmation Email Sent
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Contact Info Confirmed
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Fund Return Amount Confirmed
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Select...
Continue my TQU Membership and deduct the Annual Membership fee from my Fund Return Amount.
End my VIP Lifetime Membership and TQU Membership after the full Fund Return.
Membership Selection Made
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Membership Selection Confirmed
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Bank Info Confirmed
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Fund Return Authorization
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Not Required
Device Issued
Awaiting Return
In Transit
Returned
Device Return Status
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Device Returned Date
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Device Tracking Number
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Update Recipient Information
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LEGAL OFFICE USE: Kirk and Dru
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Request Received
Under Review
Approved
Awaiting Bank Verification
Ready for Wire
Wire Initiated
Return Completed
Closed
Fund Return Status
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Adjusted Return Amount
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Bank Info Confirmed
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Wire Initiated Date
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Wire Confirmation Number
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Submit Updated Wire Information
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Bank Information
Member Name:
Mobile Number:
Member Email:
[Related Object Email]
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Bank name
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Bank Address
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Name on Bank Account (Personal name, Trust, Business)
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Member's Phone Number Associate with Account
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Bank Account Number
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Bank Routing Number
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ACH or International Swift code:
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Mexico Bank CLABE
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Submit
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