Chesapeake, VA · City of Chesapeake
Request for Refund or Prorated Amount
Vehicle owners use this form to report a move into or out of Chesapeake, or that they no longer own a vehicle, to the Commissioner of Revenue’s Office.
What this form is
Use this form when you have moved into or out of Chesapeake with a vehicle, or no longer own the vehicle, so the Commissioner of Revenue’s Office can review your request for a refund or prorated amount. It asks for vehicle and owner details, your move or vehicle-disposition information, and a signature. Depending on your situation, it may also require an out-of-state registration or current leave and earnings statement.
Who needs it
Vehicle owners who moved into or out of Chesapeake, or no longer own the vehicle, can complete the applicable section and return the form.
How to submit it
Sign and return the completed form to Victoria L. Proffitt, Post Office Box 15285, Chesapeake, Virginia 23328. Questions: 757-382-6455 or [email protected].
About notarization
This document is signed without a notary; the signer just signs and dates it, and the form lists no notarized or sworn attachment.
How to submit this form
- 1
Download The Form
Download the Request for Refund or Prorated Amount form.
- 2
Complete The Vehicle Details
Provide the vehicle and owner information, then fill in the section that applies to your situation.
- 3
Gather Any Required Attachment
For a move out of Chesapeake, attach out-of-state registration; active-duty military applicants must include a current LES.
- 4
Sign And Return The Form
Sign and date the form, then return it to the address shown in the document.
Frequently asked questions
- Do I need a notary for this refund request?
- No. The form has a signature and date line but no notary block; it lists no notarized or sworn attachment.
- How do I submit the completed form?
- Sign and return it to Victoria L. Proffitt at Post Office Box 15285, Chesapeake, Virginia 23328. The form lists 757-382-6455 and [email protected] for questions.
- What information does the form ask for?
- It asks for vehicle details, owner names and contact information, and information about moving into or out of Chesapeake or no longer owning the vehicle.
- Do I need to attach any documents?
- If you moved out of Chesapeake, Section 2 says to attach out-of-state registration. If you are active-duty military, the form says to return it with a current LES.
Need something notarized?
This Request for Refund or Prorated Amount doesn’t need a notary — but if you have another Chesapeake form that does, a commissioned online notary can help.