Imperial — Request for Refund(eFiling)

Source: https://www.imperial.courts.ca.gov/system/files/forms-and-filings/request-refundefiling.pdf

NAME, ADDRESS, AND TELEPHONE NUMBER OF ATTORNEY OR PARTY WITHOUT ATTORNEY: STATE BAR NUMBER Reserved for Clerk’s File Stamp

ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF IMPERIAL

COURTHOUSE ADDRESS:

PLAINTIFF:

DEFENDANT:

CASE NUMBER:

REQUEST FOR REFUND

IF YOU ARE REQUESTING A REFUND FOR A FEE PAID THROUGH EFILING, attach documentation which substantiates that the court erred in calculating or processing a fee.

I am requesting a refund in the amount of $ for the following reasons:

Date of payment/deposit: Amount Paid: $_ Receipt #:

Payor: Printed Name

Address: Number Street City State Zip

Signature: _____________________ Dated:

TO BE COMPLETED BY THE COURT:

Request for refund: ☐ Approved ☐ Denied

Refund request denied on the basis of:

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Date: ________________________ By: ______________________________________________________

REQUEST FOR REFUND