Form 70-0804 "Cash Bond Assignment and Refund Authorization" - Arizona

What Is Form 70-0804?

This is a legal form that was released by the Arizona Department of Transportation - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2011;
  • The latest edition provided by the Arizona Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 70-0804 by clicking the link below or browse more documents and templates provided by the Arizona Department of Transportation.

ADVERTISEMENT
ADVERTISEMENT

Download Form 70-0804 "Cash Bond Assignment and Refund Authorization" - Arizona

Download PDF

Fill PDF online

Rate (4.8 / 5) 11 votes
Mail Drop 529M
CASH BOND ASSIGNMENT &
Collections Unit
Arizona Department of Transportation
REFUND AUTHORIZATION
PO Box 2100
Phoenix AZ 85001-2100
www.azdot.gov
70-0804 R09/11
Clear
Request Date
Control Number
ADOT Account Number
IFTA Account Number
AZ
Account Name
If any portion of the cash bond is to be assigned, attach the documentation.
Comments
Refund Paid To
Address
City
State Country
Zip
Cash Bonds — Tran Code 500 IF
Bond Number
Refund Amount
Batch/Claim Number
Warrant Number
$
Assignment Amount
Batch/Claim Number
Warrant Number
$
• Make assignment warrant payable to: Motor Vehicle Division
• Return all warrants to the Collections Unit supervisor
Prepared By
Preparer Signature
Phone
Date
(
)
Approved By
Approver Signature
Phone
Date
(
)
Accounting Signature
Date
Cash Receipts Use Only
Warrants Attached
Refund only (one warrant)
Assignment only (one warrant)
Refund and Assignment (two warrants)
Mail Drop 529M
CASH BOND ASSIGNMENT &
Collections Unit
Arizona Department of Transportation
REFUND AUTHORIZATION
PO Box 2100
Phoenix AZ 85001-2100
www.azdot.gov
70-0804 R09/11
Clear
Request Date
Control Number
ADOT Account Number
IFTA Account Number
AZ
Account Name
If any portion of the cash bond is to be assigned, attach the documentation.
Comments
Refund Paid To
Address
City
State Country
Zip
Cash Bonds — Tran Code 500 IF
Bond Number
Refund Amount
Batch/Claim Number
Warrant Number
$
Assignment Amount
Batch/Claim Number
Warrant Number
$
• Make assignment warrant payable to: Motor Vehicle Division
• Return all warrants to the Collections Unit supervisor
Prepared By
Preparer Signature
Phone
Date
(
)
Approved By
Approver Signature
Phone
Date
(
)
Accounting Signature
Date
Cash Receipts Use Only
Warrants Attached
Refund only (one warrant)
Assignment only (one warrant)
Refund and Assignment (two warrants)