Request for Refund of Fees Paid Electronically 1 [Rev. 01/2018] Attorney's name, bar number Attorney's e-mail address Firm name Business mailing address City, state, and 9-digit zip code Area code and telephone number Attorney for [Plaintiff/Defendant] UNITED STATES DISTRICT COURT DISTRICT OF OREGON PLAINTIFF NAME(S) , Plaintiff, Case No.: X:XX - cv - XXXX - XX v. DEFENDANT NAME(S) , Defendant. REQUEST FOR REFUND OF FEES PAID ELECTRONICALLY The following filing fee refund request is made pursuant to the procedures set forth in Standing Order 2011-9 for refunding erroneous or duplicate electronic filing fee payments. The reason for and amount of the refund request are as follows: [Insert reason and amount requested.] [Include refund requestor's name, address, and telephone number if different from attorney information captioned above.] Attached hereto is supporting documentation including a copy of the electronic payment receipt and a copy of the Notice of Electronic Filing (NEF) from the system transaction in CM/ECF during which the payment was made. American LegalNet, Inc. www.FormsWorkFlow.com Request for Refund of Fees Paid Electronically 2 [Rev. 01/2018] Dated: . Attorney name, bar number American LegalNet, Inc. www.FormsWorkFlow.com