Disputes Form: This form will be directed to our Refund Group. We appreciate your comments! Customer First/Last Name: * License Plate Customer Telephone Number: * Customer Email Address: * Cashier PIN# Supervisor Email * Parking Area: * Terminal AB Terminal C Terminal DE ecopark :: IAH ecopark 1 :: Hobby ecopark 2 :: Hobby Hobby Terminal Lane # Issue Experienced Parking Plus Member Surepark Member Used the Credit Card In/Out Automated Machine Pulled a ticket; but paid the Instapark Machine on Exit Paid the Cashier with my credit card Coupon Issue Reservation Other Date of Exit: * Charge Amount: * Dispute Amount * RES/COUPON #: First 4 digits of credit card * Last 4 digits of credit card: * Reason for Dispute: File