Free Request for Fee Refund (pdf format) - Kentucky

SAMPLE DOCUMENT ONLY
UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF KENTUCKY AT (DIVISION OFFICE)

JOHN DOE PLAINTIFF V. Civil Action No. (Type Case Number)

JANE DOE DEFENDANT

REQUEST FOR FEE REFUND (Party), by counsel, respectfully submits this request for Fee Refund with respect to the (amount) fee in Receipt No. (type number*). When attempting to file (what type of document) on (date), counsel encountered a technical failure/docketing error, and did not receive confirmation of filing. Furthermore, this technical failure required re-filing of the document, which is reflected in Receipt No. (type number). Based upon such facts, the (party) respectfully seeks a refund of the fee for this duplicate filing.

Date: S:/ type name Signature Block

Certificate of Service

* To locate this information, log into ECF, click onto Utilities, Miscellaneous and Internet Payments Made