Fillable POOL PASSES MUST BE SURRENDERED IN ORDER TO

Fill Online, Printable, Fillable, Blank POOL PASSES MUST BE SURRENDERED IN ORDER TO Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

POOL PASSES MUST BE SURRENDERED IN ORDER TO

On average this form takes 5 minutes to complete

The POOL PASSES MUST BE SURRENDERED IN ORDER TO form is 1 page long and contains:

  • 0 signatures
  • 0 check-boxes
  • 21 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
NAME: DATE:
ADDRESS:
PHONE:
Please choose one:
QUANTITY TOTAL DUE
Pass
Year
1 $60.00 / 2 = $30.00 (2019)
1 $30.00 ea (2020)
Pass
Year
$
135.00 / 2 = $67.50 ea (2019)
$
67.50 ea (2020)
$15.00 ea / 2 = $7.50 ea (2019)
$7.50 ea (2020)
TOTAL REFUND:
Date
First 5
100-450-20
City of Milton-Freewater
AQUATIC CENTER REFUND VOUCHER
SEASON PASS - INDIVIDUAL
SEASON PASS -FAMILY
DETAIL
AMOUNT
TO BE COMPLETED BY CITY STAFF
REFUND me equal to (50%) of the regular pass rate I paid for a 2019 season pass. I HAVE NOT RECEIVED A PRIOR REFUND OR 2020 PASS IN
EXCHANGE FOR THE 2019 PASS. Please provide passholder info below.
100-450-20
Additional Family Members (if over 5)
I received a 2020 season pass in lieu of a 2019 refund = to 50% - I NOW WANT TO RECEIVE A REFUND = to 50% of the pass price I paid in 2019.
Please provide passholder info below.
POOL PASSES MUST BE SURRENDERED IN ORDER TO RECEIVE A REFUND
I understand that the above option chosen is to compensate me for the remainder of the 2019 / 2020 aquatic center season and that
upon such choice I am due no further compensation or services from or by the City of Milton-Freewater, Oregon.
Signature
REFUND me equal to the pass rate I paid (PRIOR TO 7/28/20) for a 2020 season pass. Please provide passholder info below.
ACCOUNT
Name:
100-450-20
100-450-20
100-450-20
VERIFIED/APPROVED:
CK# ________
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

POOL PASSES MUST BE SURRENDERED IN ORDER TO

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 28 January 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document