On August 22, 2018 a
Request,Application
was filed
involving a dispute between
Ppr Cs Manager Inc.,
and
Kr Hollywood Llc,
for civil
in the District Court of Los Angeles County.
Preview
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U 6 NOV 09 .2013 CASE NUMBER:
REQUEST FOR REFUND FILING W|NDV%m4K3”/<%
NOTE: THIS FORM IS NOT TO BE USED FOR REFUND OF JURY FEES. [Use Declaration and Orer
Re: Advance Ju Fees, LASC Approved LACIV 099, to request refund ofjury fee deposit.]
IF YOU ARE REQUESTING A REFUND FOR A FEE PAID THROUGH THE COURT RESERVATION SYSTEM
(CRS), attach documentation which substantiates that the court erred in calculating or processing a fee.
I am requesting a refund in the amount of $ — O for the following reasons:
//I /51' 5/ /‘£Doz5/ ax‘ /I/r :46 ’-/ . ,
68 U/l o W? -€Fen(,:€ . _ €i’i'airr(~ ' 0 \ lxoocg
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Date of payment/deposit: 27 Amount Paid: $ -0) Receipt #:
Depositor: ['6 ‘Li O//+
, P ' d N
Address: I r (/63?? 5 5f 900%
ber 2 Stre City State Zip
Signature: Dated: I [ ' 2 ' .
TO BE COMPLETED BY THE COURT:
ili '
Requeg for Refund: El Requires judicial approval D Requires manager's approval only
I/2(Approve D Denied Refund #:
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By: .i _ Dated: /( 6 I / 5/
Judicial Oicer/Managers Signature
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Pn‘ntedName
:L§§§:;£§§;§'vEe‘:§;o%?31s5’ REQUEST FOR REFUND // /72 03 35
Document Filed Date
November 16, 2018
Case Filing Date
August 22, 2018
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