Holder Reimbursement & Refund Request Holder Reimbursement Request Holders requesting a reimbursement for funds returned to owners should complete a Holder Reimbursement Request Form. Holder Refund Request Holders requesting a refund for property remitted or delivered in error should complete a Holder Refund Request Form. After printing the form(s) on standard 8.5 x 11 paper, complete the form and mail it to the address listed on the form. Don't forget to include documentary evidence when submitting a reimbursement and/or refund request. The request(s) should be signed by two officers.