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On-Street Overcharge/Refund Request Form

*Refunds can only be made to the individual/entity that made the payment
*Refunds are subject to verification of machine malfunction on the date, and time of the incident
*Maximum refund allowed: $20.00 (basis for refund will be max of daily rate)

I CERTIFY THAT I HAVE READ THE ABOVE AND THAT THE CONDITIONS ARE TRUE.

For questions, please call (562) 570-3264 or e-mail PW_-_Traffic_Operations_Division@longbeach.gov.

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