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NOTICE OF APPEAL Please attach the refundable appeal fee of $150.00. A) Individual/Organization Filing Appeal (the “Appellant “) NAME: DATE: ADDRESS: HOME PHONE NUMBER: EMAIL ADDRESS: WORK PHONE
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Please attach form refundable is a form required for requesting a refund of certain expenses.
Individuals or businesses who have incurred eligible expenses and are seeking a refund are required to file please attach form refundable.
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The purpose of please attach form refundable is to allow individuals or businesses to request a refund for specific expenses they have incurred.
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