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4-digit restaurant number: Input digits 1-4 of survey code

Sale number: Input 4-digit sale number

Date: VisitDateMonth -- 010203040506070809101112 / Day -- 01020304050607080910111213141516171819202122232425262728293031 / Year -- 2223

Time: Hour -- 010203040506070809101112 : Minute -- 000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859   Meridiem -- AMPM

I have an 18-digit code on my receipt.

I do not have a receipt.

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