GUSFLOW — DELIVERY ADJUSTMENT CASE LOG
One copy per adjustment. Complete this with your actual records.
Guide: https://gusflow.com/resources/delivery-refund-disputes

Platform:
Store reference:
Order reference:
Order date:
Delivery date (if different):
Adjustment transaction reference:
Adjustment date:
Adjustment amount and currency:
Reported issue:
Account-displayed deadline and time zone:

RECORDS CHECKED
Order ticket / modifiers:
Packing record and timestamp:
Handoff record and timestamp:
Adjustment statement:
What the records establish:
What the records do not establish:

ACTION LOG
Submitted through my authorized merchant account on:
Submission / case reference:
Status and last checked date:
Decision and decision date:
Approved credit amount (only after approval):
Credit transaction reference and date:
Payout reference and period:
Matched bank deposit date:
Unresolved difference / next action:

CHECK BEFORE CLOSING
- A draft is not a submitted dispute.
- A submission confirmation is not approval.
- Approval is not proof that a credit reached the bank.
- Match the adjustment, credit and payout before marking the case complete.
- Record legitimate restaurant errors as such. Do not invent evidence.
- Keep customer addresses and payment information out of this working log.

Original Gusflow working template, 2026-09-20.
Not an official platform form. No account access or submission is provided.