Fill in the name of the payee. Write the recipient's name next to "Pay to the order of." Fill in your address in the "purchaser" section. Fill in the recipient's name. Fill in the name of the recipient in the "pay to" section. Complete the fields below to proceed with your refund request. If you don't have the original copy of the money order or receipt, please fill this form instead. Acceptable forms of payment include cash, money orders, checks, and credit cards. We also offer a money-on-deposit (MOD) account if you are a frequent filer. Submit a check, money order or cashier's check (Made payable to Green Valley Justice Court) along with the form listed above, in the envelope provided to you.