LSAT
®
& LSAC Cre den tial As sem bly Service
SM
(CAS
SM
)
Re fund Re quest Form
Last Name First Name Middle Initial
Last Four Digits of Social Security or Social Insurance Number Date of Birth (MM/DD/YYYY)
Street Ad dress or PO Box; in clude apart ment num ber, if ap pli ca ble
City State/Prov ince
L
Test Center Number LSAC Account Number
Note: Please check if new address.
Phone Number
US Zip/Postal Code Country
LSAT fees are only partially refundable due to the fact that processing costs are incurred in the registration process,
regardless of whether you actually take the test.
In accordance with LSAC’s refund policy, please process my refund request for the service(s) checked below:
LSAT
June 2018
July 2018
September/October 2018
November 2018
January 2019
March 2019
June 2019
Note: A completed and signed request must be received by the applicable receipt deadline (deadlines located on LSAC.org), or it will
not be processed. If your request for a refund is not received by the applicable receipt deadline date as specified at LSAC.org,
you may still withdraw your registration. Access your LSAC.org account and navigate to the LSAT tab and LSAT status page.
Follow the instructions to withdraw your test registration by the specified withdrawal deadline. Withdrawing your registration
will prevent an absentee notation from appearing on your LSAT Law School Report. Withdrawals cannot be rescinded. Refund
request deadlines will not be extended for those who submit a request form that is incomplete or is missing a signature.
LSAC Cre den tial As sem bly Ser vice (CAS)
CAS Registration
Note: CAS fees are only partially refundable due to the fact that processing costs are incurred in the registration process,
regardless of whether you actually use the service. CAS fees are not refundable if transcript summarization has begun, or if any
letter of recommendation/evaluation has been received, or if any electronic applications have been sent to LSAC for processing,
or if your CAS registration has expired. Should you need CAS reporting in the future, it will be necessary for you to completely
reregister and pay full CAS fees.
Important: Read the following statement. Sign your name and enter the date. If the statement is not signed and dated, it
will not be processed.
The Law School Admission Council
TM
(LSAC
®
) will not process this form if this statement has been modified or altered in any way.
I authorize LSAC to process a refund for my LSAT/CAS file, as requested above. I certify that I have read LSAC’s policies at LSAC.org and am aware
that my account will be refunded and my registration will be canceled in accordance with published refund policies.
Signature Date
Return this form to: Law School Admission Council
Re fund Re quest
662 Penn Street
PO BOX 2000-T
New town PA 18940-0995
USA
Fax to 215.968.1277 or scan and email to LSACrefunds@LSAC.org.
© 2018 by Law School Ad mis sion Coun cil, Inc. All rights re served. LSAC and LSAT are reg is tered marks of Law School Ad mis sion Coun cil, Inc. 5/2018