Pennsylvania > Local County > Philadelphia > Civil Trial
Prothonotary Refund Application 10-285 - Pennsylvania
| Prothonotary Refund Application Form. This is a Pennsylvania form and can be used in Civil Trial Philadelphia Local County . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
FIRST JUDICIAL DISTRICT OF PENNSYLVANIA COURT OF COMMON PLEAS OF PHILADELPHIA OFFICE OF THE PROTHONOTARY PROTHONOTARY REFUND APPLICATION Return to: ROOM 282 CITY HALL PHILADELPHIA PA 19107 or Fax to 215-686-3793 NAME AND ADDRESS OF PAYEE: ________________________________ ________________________________ ________________________________ ________________________________ APPROVED BY: _______________________________ Prothonotary, Finance Dept. Amount of Refund Request: $______________________________ CASE CAPTION: ________________________________ Court Term & Number: _______________________________ VS. ________________________________ STATEMENT OF FACTS: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Note: Please attach your original cash register receipt or proof of payment, along with a copy of the civil docket report. PAYEE'S SIGNATURE: ________________________________ Date: __________________________ American LegalNet, Inc. www.FormsWorkFlow.com
|
|||||||
