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Get Claim For Refund Application - City Of Los Angeles - Office Of Finance - Finance Lacity

3) Return Signed Original To: Office of Finance, Refund Processing P.O. Box 53200, Los Angeles, CA 90053-0200 (213) 744-9724 Date: Name of Claimant: DBA (Doing Business As): Business Address: Mailing Address: Location of Financial Records: Phone Number: 2. Date of Payment: 1. Amount Claimed Overpaid: 3. Tax Registration Certificate and/or Permit Number: 4. City Department to which Payment was made: 5. Reasons for filing claim: (Give full details. If more space is required, select Page 2 and.

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