Request for Refund of Graduated Filing Fees NAME, ADDRESS, AND TELEPHONE NUMBER OF ATTORNEY OR PARTY WITHOUT ATTORNEY: THIS FORM MUST BE SUBMITTED ON YELLOW PAPER STATE BAR NUMBER Reserved for Clerk's Lodged Stamp ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES COURTHOUSE ADDRESS: Estate of: Reserved for Clerk's Filed Stamp REQUEST FOR REFUND OF GRADUATED FILING FEES (Decedents' Estates - Probate) NOTE: THIS FORM IS NOT TO BE USED WHEN THE COURT HAS ORDERED FINAL DISTRIBUTION, UNLESS THE ORDER ALLOWS A REFUND OF GRADUATED FILING FEES. For additional information refer to Los Angeles Superior Court's Notice to Attorneys, Refund of Graduated Filing Fees. ] the personal am [ I, ] was the petitioner in the first representative of the above referenced estate OR [ filed petition for probate. CASE NUMBER: My address is: Street Address City State Zip Code TO BE COMPLETED FOR OPEN CASES WHEN THE COURT HAS NOT MADE AN ORDER FOR REFUND OF THE GRADUATED FILING FEE In support of this request for refund I allege: The first Petition for Probate was filed with the Court on: If the applicant is not the personal representative of the estate, the name(s) of the personal representative(s) of the estate: The address of the personal representative, if pro per, or name and address of his/her attorney of record: Street Address City State Zip Code Date of payment: Amount of payment: Receipt number: Date of payment: Amount of payment: Receipt number: Request for Refund of Graduated Filing Fees Decedents' Estates - Probate PRO 022 (NEW 05/08) ADMIN Approved Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com Request for Refund of Graduated Filing Fees THIS FORM MUST BE SUBMITTED ON YELLOW PAPER I am requesting a refund of the graduated filing fee in the amount of $ , calculated as follows: $ Total amount of my payment(s): Less, the amount of base fee plus local add-ons: TOTAL AMOUNT OF REFUND CLAIMED: $ [ [ ] Mail the refund to my address as noted above. ] Mail the refund to me at the following address: City State Zip Code Street Address TO BE COMPLETED WHEN THE COURT HAS MADE AN ORDER ALLOWING A REFUND OF THE GRADUATED FILING FEE allowing a refund of the graduated filing fee in the sum Attached is a copy of this Court's order dated . That order provides for payment of the refund as follows: of $ ] To the applicant herein, as personal representative of the estate of the above-named decedent. [ ] To the persons as specified in the order attached hereto. [ I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Dated: Signature Dated: Signature TO BE COMPLETED BY THE COURT Refund: Reason for denial: [ ] Approved [ ] Denied [ ] The graduated filing fee paid was equal to the base fee plus local add-ons, in the year of filing, and no refund is due. [ ] The applicant was not the initial (first) filer and did not pay the graduated filing fee. and any [ ] Petition for Final Distribution was approved per Minute Order dated request for refund must be made in a properly filed and noticed petition/motion. [ ] The order allowing refund of the graduated filing fees is not attached as alleged. [ ] Other: By: Dated: Signature [ ] Probate Attorney [ ] Probate Examiner TO BE COMPLETED BY THE CLERK ISSUING REFUND ORDER By: Deposit Refund Order #: Date: Printed Name / Refund Clerk Request for Refund of Graduated Filing Fees Decedents' Estates - Probate PRO 022 (NEW 05/08) ADMIN Approved Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com