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Get Subcard Lost Card

Fully complete the information requested below and mail this form along with your damaged/unreadable card and your original receipt to IPC/Value Pay Services LLC PO Box 962678 El Paso TX 79996 Attn SUBWAY Card Replacement Request Customer Information Name Address City State ZIP Phone Number Email Address SUBWAY Card Number Only cardholders that have previously registered their card are eligible for replacement of damaged or unreadable cards. Replacement Request Form If your SUBWAY Card is damaged lost or stolen 1. Call 1-877-697-8222 IMMEDIATELY to have your account balance frozen* 2. For properly submitted claims a new SUBWAY Card will be issued for the amount remaining on the damaged or Post. Doctor s Associates Inc* Independent Purchasing Cooperative and Value Pay Services LLC are not responsible for lost stolen misdirected damaged or illegible claims or mail* Allow 2-3 weeks for delivery of replacement SUBWAY Card. By signing below I do hereby certify under penalty of law that the above information is true and correct and that I am the lawful owner through purchase or gift of the enclosed card. Fraudulent claims will be prosecuted to the fullest extent of the law. Signature Date 2011 Doctor s Associates Inc* SUBWAY is a registered trademark of Doctor s Associates Inc*. For properly submitted claims a new SUBWAY Card will be issued for the amount remaining on the damaged or Post. Doctor s Associates Inc* Independent Purchasing Cooperative and Value Pay Services LLC are not responsible for lost stolen misdirected damaged or illegible claims or mail* Allow 2-3 weeks for delivery of replacement SUBWAY Card. Doctor s Associates Inc* Independent Purchasing Cooperative and Value Pay Services LLC are not responsible for lost stolen misdirected damaged or illegible claims or mail* Allow 2-3 weeks for delivery of replacement SUBWAY Card. By signing below I do hereby certify under penalty of law that the above information is true and correct and that I am the lawful owner through purchase or gift of the enclosed card. By signing below I do hereby certify under penalty of law that the above information is true and correct and that I am the lawful owner through purchase or gift of the enclosed card. Fraudulent claims will be prosecuted to the fullest extent of the law. Signature Date 2011 Doctor s Associates Inc* SUBWAY is a registered trademark of Doctor s Associates Inc*. For properly submitted claims a new SUBWAY Card will be issued for the amount remaining on the damaged or Post. Doctor s Associates Inc* Independent Purchasing Cooperative and Value Pay Services LLC are not responsible for lost stolen misdirected damaged or illegible claims or mail* Allow 2-3 weeks for delivery of replacement SUBWAY Card. By signing below I do hereby certify under penalty of law that the above information is true and correct and that I am the lawful owner through purchase or gift of the enclosed card. Doctor s Associates Inc* Independent Purchasing Cooperative and Value Pay Services LLC are not responsible for lost stolen misdirected damaged or illegible claims or mail* Allow 2-3 weeks for delivery of replacement SUBWAY Card. By signing below I do hereby certify under penalty of law that the above information is true and correct and that I am the lawful owner through purchase or gift of the enclosed card. Fraudulent claims will be prosecuted to the fullest extent of the law. Signature Date 2011 Doctor s Associates Inc* SUBWAY is a registered trademark of Doctor s Associates Inc*.

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