Attorney Refund Request

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Clerk of the Circuit and County Courts
11th Judicial Circuit
Miami-Dade County
ATTORNEY E- FILING REFUND REQUEST FORM
Date of Request:
/
/
Attorney Contact Information
Attorney's Name:
Attorney Bar # :
Telephone #:
E-Mail Address:
Original Transaction
Email to location originally filed at:
COC
REFUND@MIAMIDADE.GOV
Example: COCFamily REFUND@MIAMIDADE.GOV
South Dade
Choose one of the following:
Family
Probate
Coral Gables
Miami Beach
Hiealeah
Circuit Civ
Cnty Central
North Dade
Date Filed:
/
/
E-Filing #:
Amount Originally Paid: $
Case #:
(Local Case Number)
Refund Information
Requested Refund Amount: $
Make Refund Payable To (Choose One):
Registered Organization
Registered Attorney
Name:
Name:
Address:
Address:
Authorizing Signature:
Reason for Refund:
M:\Attorney E Filing Refund Request.xls
Created 02/01/13

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