The introductory part of the application reserved for the details. It is traditionally located at the top left of the sheet. This part is mandatory. The statement is always written in the name of the first head, so here write title, surname, name and patronymic of Director of the company with which you plan to calculate. Next, specify your own name, residence and phone numbers for contacts.
At the center of the page place the title of the document "Statement" and immediately under it briefly the essence of the appeal: "the refund". In substantial part, describe the situation and circumstances, allowing you to claim reimbursement of the paid amounts. Try to avoid unnecessary details, but focus on the essence of the case. List the facts, refer to confirming the validity of your requirements documents and articles legislation. Enter the desired refund amount, after the words "Please return to me."
In the final part provide possible ways of calculation with you if required. For cashless payment, specify your Bank details for the postage let address. Then list any attached documents or their copies (checks, receipts, certificates, etc.). Check the date of the application and sign.
The application shall be personally and, in the case of disputed questions, to pass it on receipt to the responsible person. This will help to avoid a common situation where your opponents are, wanting to delay the resolution of the issue would argue that there was no written treatment. In addition, you can also send your application by registered letter with acknowledgment of receipt. For subsequent appeals to the courts will be useful for you and that the postal receipt.
Some agencies develop their own forms that serve as a model for such treatment. But most often it consists in a free form by hand, but with the features of business rules.