Client's Name and Address: Provide the client's name and address as it appears in payment system. 2. Date: Enter the date that the DSHS 18-398 is filled out. 3.Who should file this form? A seller who is claiming a refund or credit to their account for overpaid taxes, penalties, or interest. Find out why you got the overpayment. Usually, either ESD or an "administrative" judge decided you were ineligible. 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. Complete a Refund Notification (PDF) form. Requests to appeal the overpayment must be submitted in writing to the department within 30 days of the overpayment notification.