Lumpkin County, GA · Lumpkin County
Program Refund Request Form
Lumpkin County Parks and Recreation participants use this form to request a refund and provide payment, program, participant, and contact details.
At a glance
- Issued by
- City of Lumpkin County · Lumpkin County, Lumpkin County, Georgia
- Notarization
- Not required: file this form without a notary.
- Official source
- lumpkincounty.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This form lets a participant request a refund for a Lumpkin County Parks and Recreation program. It asks for the refund amount, reason, program, participant’s name, payment recipient and address, phone numbers, and the signer’s signature and date. The form states that a $15 administrative fee is deducted from refunds and explains when refunds are available.
Who needs it
A participant seeking a refund for a Parks and Recreation program should complete and sign this request form.
How to submit it
Submit the form to the Lumpkin County Parks and Recreation Department at 365 Riley Road, Dahlonega, Georgia 30533. The form also lists phone and fax numbers.
About notarization
This document is signed without a notary; the signer just signs and dates the request.
How to submit this form
- 1
Download the Form
Download the Program Refund Request Form PDF.
- 2
Complete the Request
Enter the payment, contact, refund, program, and participant information requested on the form.
- 3
Sign and Date
Sign and date the request. The document does not list any required attachments.
- 4
Submit to the Department
Send the form to Lumpkin County Parks and Recreation Department, 365 Riley Road, Dahlonega, Georgia 30533.
Frequently asked questions
- Do I need a notary for the Program Refund Request Form?
- No. This document is signed without a notary; the signer just signs and dates the request.
- How do I submit the Program Refund Request Form?
- Submit it to the Lumpkin County Parks and Recreation Department at 365 Riley Road, Dahlonega, Georgia 30533. The form also lists the department’s phone and fax numbers.
- What information does the refund form request?
- It asks for the refund amount and reason, program and participant name, payment recipient and address, home and cell phone numbers, and the signer’s signature and date.
- Is there an administrative fee for refunds?
- The form states that a $15 administrative fee will be deducted from the original amount paid for all refunds. It also describes when refunds are available.