Get Reimbursement Request Examples - State Water Resources - Waterboards Ca

Filling out the Reimbursement Request form for the Underground Storage Tank Cleanup Fund can seem daunting, but it is an essential step for getting reimbursement for eligible costs incurred. This guide will walk you through each section of the form to ensure a straightforward and successful submission.

Follow the steps to successfully complete your reimbursement request online.

1. Click the ‘Get Form’ button to obtain the reimbursement request form and open it in your online editor.
2. Fill in the claim number in the designated space. This is critical as it links your reimbursement request to your specific claim.
3. Provide your name as the claimant, along with any co-payee or joint claimant details, if applicable. Ensure all spellings are correct for processing.
4. Enter the mailing address where you would like correspondence sent. If your address has changed, check the box and complete the address change form.
5. Indicate the contaminated site's address and region number. Accurately specify the location for proper processing of your request.
6. Enter the total project costs incurred to date in the respective fields under the 'Project Costs Incurred to Date' section. Remember to ensure these costs are cumulative and total-to-date, not incremental.
7. Sign and date the certification section, confirming that you have read the conditions of payment and that all information is accurate.
8. Once all fields are completed, you can save your changes, download the form, print it, or share it as necessary for final submission.

Complete your reimbursement request online today to ensure timely processing of your funds.