Coolidge, AZ · Pinal County
Refund Request
This form lets a person or firm request a refund for a city permit or application fee and provide the reason and payment recipient details.
What this form is
Use this form to request a refund related to a city permit or application, giving the request date, permit or application number, reason, requester contact details, and remittance address. The form states that a refund can be issued only to the person or firm that paid the fee or their authorized representative, and that the refund will be issued to the name and address provided.
Who needs it
A person or firm seeking a refund for a city fee, or their authorized representative, can use this form to provide the request and remittance details.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This request is signed and dated without a notary; the form lists no sworn attachment or notarized step, so the requester just signs and dates it.
How to submit this form
- 1
Download The Form
Download the Refund Request PDF.
- 2
Complete The Request
Enter the request date, permit or application number, reason, contact information, and remittance address.
- 3
Sign The Form
Sign the requester signature line.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What information does the Refund Request ask for?
- It asks for the request date, permit or application number, reason for the request, requester contact details, remittance address, and requester signature.
- Who can receive the refund?
- The form says a refund can be issued only to the person or firm that paid the fee or their authorized representative. The refund goes to the name and address provided.
- Do I need a notary for the Refund Request?
- No. This form is signed and dated without a notary, and it lists no sworn attachment or notarized step.
- How do I submit the Refund Request?
- Submit it to the city department named on the form; check the city website for current contact details.