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Claim For Refund ACR 197P - California

Claim For Refund Form. This is a California form and can be used in Clerk Recorder Assessor County Clerk Recorder Riverside Local County .
 Fillable pdf Last Modified 7/9/2007
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LARRY W. WARD COUNTY OF RIVERSIDE ASSESSOR-COUNTY CLERK-RECORDER County Clerk-Recorder P.O. Box 751 Riverside, CA 92502-0751 (951) 486-7000 CLAIM FOR REFUND The undersigned declares that payment in the amount of Riverside for the following: $ has been made to the County of Type of document Receipt number Date Doc. # if applicable A refund in the amount of $ is requested. EXPLANATION: I hereby certify, under penalty of perjury, that the facts stated above are true and correct. No previous claim for refund has been submitted. NAME OF CLAIMANT: SIGNATURE ADDRESS CITY, STATE, ZIP CODE PHONE # DATE: FOR RECORDER DEPT. USE ONLY IT IS RECOMMENDED THAT THIS REQUEST BE: RIVERSIDE COUNTY CLERK-RECORDER APPROVED: DENIED: BY: DATE: ACR 197P-AS2AC0 (Rev. 02/2007) Available in Alternate Formats American LegalNet, Inc. www.FormsWorkflow.com
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