School Developer Fee Refund Request Form
Reason for Refund
*
Square Footage Decreased (Partial Refund)
Project Abandoned/Cancelled/Expired (Full Refund)
Did construction commence on the Project?
*
Yes
No
Date Project Updated
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date Project was Cancelled or Square Footage was Reduced
Date Fees Paid
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Address for File Name
Project Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Receipt Number
*
This is the 6-digit number from the Certificate of Compliance
Amount Paid
*
Refund Amount
*
Building Project Number
*
City or County Provided Project Number
Refund Requestor
*
First Name
Last Name
Original Check Payor Name
*
First Name
Last Name
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Requestor Email
*
Confirmation Email
example@example.com
Requestor Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Facilities' Notes
How would you like to receive your check?
*
USPS Mail
In Person at Facilites
Signature
*
Facilities to Upload Payment File
Browse Files
Drag and drop files here
Choose a file
Provide a copy of the original payment
Cancel
of
Facilities to Upload City or County Status File
Browse Files
Drag and drop files here
Choose a file
Provide a copy of the City documentation
Cancel
of
Developer Fee Account
Please Select
CoLB R1 25-9051-0-0000-0000-8683-781
CoLB R2 25-9051-0-0000-0000-8684-781
CoLB C 25-9051-0-0000-0000-8682-781
CoLB M 25-9051-0-0000-0000-8681-781
LKWD R1 25-9051-0-0000-0000-8683-782
LKWD R2 25-9051-0-0000-0000-8684-782
LKWD C 25-9051-0-0000-0000-8682-782
LKWD M 25-9051-0-0000-0000-8681-782
SH R1 25-9051-0-0000-0000-8683-783
SH R2 25-9051-0-0000-0000-8684-783
SH C 25-9051-0-0000-0000-8682-783
SH M25-9051-0-0000-0000-8681-783
AVALON R1 25-9051-0-0000-0000-8683-780
AVALON R2 25-9051-0-0000-0000-8684-780
AVALON C 25-9051-0-0000-0000-8682-780
AVALON M 25-9051-0-0000-0000-8681-780
File Name
Submit
Should be Empty: