the Lily Auction Account Refund Request


Email address of seller: _________________________________


Name of seller: _________________________________


Postal Address of seller: _______________________________________

                           _______________________________________



Please refund me $ ________ from my Lily Auction account.


Any additional information? ______________________________________


Your signature and date: _________________________________________

Mail this form to:

the Lily Auction
P.O. Box 28
Papaikou, HI  96781-0028


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