San Bernardino County - Local Forms. You can use a template to create your own form for this type of request.I request that the appeal(s) indicated above be withdrawn. Applicant. Agent. Signature. Find Your Court Forms. The party to whom requests for admission have been directed shall respond in writing under oath separately to each request. To begin the process of clearing your record in San Bernardino County, fill out the form below (two parts). These local forms are provided free of charge for downloading. Most of the documents are for you to print out and fill in. Fill out and sign the enclosed REQUEST FOR ARBITRATION OF A FEE DISPUTE. Termination for cause will result in the County's immediate withdrawal and exclusion from further participation in the MCIP.