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Get Escrow Refund Claim Form - City Of Berkeley - Ci Berkeley Ca

Finance Department Revenue Collection Division Rev. April 2013 Claim For Refund of Money Paid CLAIMANT S NAME CLAIMANT S COMPLETE ADDRESS SEND NOTICES TO Include complete name and address of Attorney or Insurance Agent if representing Claimant. TELEPHONE NUMBER S AMOUNT OF PAYMENT DATE OF PAYMENT Fee Tax DOLLAR AMOUNT OF CLAIM If claim is over 10 000 state name of court jurisdiction Limited Jurisdiction case up to 25 000 Unlimited Jurisdiction ca.

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