If you do not complete and include Form 203 with your income tax return, your share of the overpayment may be applied to past due liabilities. To request a compromise of your overpayment, review this Compromise Request Form, sign and return it to the DES.Please download the form, complete each field and print. Include the form with your refund so we can properly apply the refund and record the receipt. Providers should attach documentation substantiating the overpayment, such as an EOB, if the overpayment was due to payment received from a third party payer. If we have identified an overpayment and request a refund, please mail the check along with a copy of the overpayment request letter we sent you. View options for satisfying overpayment. Submit a Voluntary Refund - A voluntary refund is when an overpayment has been self-identified.

Refund Letter To Customer For Overpayment In Arizona

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