REQUEST FOR REFUND - Atlanta 2026

1. Click ‘Get Form’ to open the REQUEST FOR REFUND - Atlanta in the editor.
2. Begin by entering the 'Date of Request' at the top of the form. This helps establish when your refund request is being made.
3. Fill in the 'Permit Number' associated with your request, followed by your 'Requestor’s Name' and 'Permit Address'. Ensure all details are accurate for processing.
4. Provide your 'Contact Number', 'Email Address', and 'Mailing Address'. This information is crucial for any follow-up regarding your request.
5. If applicable, include your 'Company Name'. Then, specify the '*Requested Refund Amount' and provide a '**Justification for Request' to support your claim.
6. Select your preferred 'Method of Payment' by checking one of the options: Credit/Debit Card, Cash, or Check. If using a card, fill in the required card information including name, number, expiration date, and security code.
7. Sign and date the form at the bottom to validate your request before submission.
8. Finally, submit your completed form via email to bjacobs@atlantaga.gov with ‘Request for Refund’ as the subject line.

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