<p> REFUND ACKNOWLEDGEMENT</p><p>For your protection as well as ours, we will need the following information as acknowledgement of refund received. </p><p>Client Name______Home Phone______</p><p>Address______Work Phone______</p><p>I hereby acknowledge that I received a CASH REFUND in the AMOUNT of $185.00 on DECEMBER 31, 2001. I hereby acknowledge that a NONREFUNDABLE PROCESSING FEE of $15.00 was withheld from original amount of payment. I hereby release DREAM DESTINATIONS TRAVEL from any further matters relating to this ticket. </p><p>Signature of Acknowledgement______Today’s Date______</p><p>Cancellation Policy: Airline Ticket: $258.50 Processing Fee: $ 15.00 Total Due: $273.50 Amount Paid: $200.00 Less Processing Fee: - $ 15.00 Refund Received: $185.00 </p><p>Dream Destinations Travel & Tours 123 Main St. Iowa Falls, IA 50126 Phone/Fax: 422-448-6928Toll Free: 877-998-5555</p>