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Welcome to the UDF Guest Feedback Survey. We value your candid feedback and appreciate you taking the time to complete our survey.

Please enter the following pieces of information from your receipt.

Store Number: Input Store Number.

Receipt Number: Input Receipt Number.

Date: VisitDateMonth -- 010203040506070809101112 / Day -- 01020304050607080910111213141516171819202122232425262728293031 / Year -- 2425

Time: Hour -- 010203040506070809101112 : Minute -- 000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859   AM or PM -- AMPM

Upon completion of this survey, you will be given a validation code that can be used to redeem the offer printed on your receipt.