Rohnert Park, CA · Sonoma County
Acknowledgement of Reimbursement Obligation
This agreement identifies the financially responsible party and sets out their payment obligations for city application processing and inspection costs.
What this form is
The financially responsible party uses this agreement to accept responsibility for reimbursable costs associated with processing an application and providing inspection services. It is not required for flat-fee applications. The signer provides contact and project details, states their relationship to the property or project, and agrees to deposit, payment, and indemnification terms.
Who needs it
The financially responsible party for an application subject to full cost recovery fees uses this agreement, unless the application has a flat fee.
How to submit it
The form identifies City of Rohnert Park Development Services and lists 130 Avram Avenue, Rohnert Park, CA 94928, and fax 707-794-9242. It does not specify how to submit the signed form.
About notarization
This document is signed without a notary; it has no notarized or sworn attachment, so the financially responsible party just signs and dates it.
How to submit this form
- 1
Download The Form
Download the reimbursement obligation form.
- 2
Complete The Agreement
Enter the financially responsible party’s contact details and the project name, description, and property address; review and accept the terms.
- 3
Review Supporting Materials
The form does not identify any required attachments; check the related application for any additional materials.
- 4
Sign And Submit
Sign and date the agreement, then use the Development Services contact information printed on the form to submit it.
Frequently asked questions
- What does the reimbursement obligation form do?
- It records the financially responsible party’s agreement to pay processing and inspection costs, including initial and additional deposits, for a project application.
- Who completes this agreement?
- The financially responsible party completes it for an application subject to full cost recovery fees. The form says it is not required for flat-fee applications.
- Do I need a notary for the reimbursement obligation form?
- No. This document is signed without a notary; it has no notarized or sworn attachment, so the financially responsible party just signs and dates it.
- How do I submit the reimbursement obligation form?
- The form lists City of Rohnert Park Development Services, its address at 130 Avram Avenue, and fax number 707-794-9242, but does not specify a submission method.
Need something notarized?
This Acknowledgement of Reimbursement Obligation doesn’t need a notary — but if you have another Rohnert Park form that does, a commissioned online notary can help.