Texas Refund Form

All refunds are mailed out on the 10th of the month after the request is received and approved. Incomplete information can result in a delay in processing.

Notes for using this form:

Complete the form below to obtain an application for a refund.
An application form will be sent to you by U.S. Mail.
Complete information in required (*) fields.
Click “Submit” when finished.

First Name*

Last Name*

Company

Operation Type

Cow/Calf

Dairy

Feedyard

Individual

Stocker

Address*

City/Town*

State/Province*

ZIP/Postal Code*

Email*

Phone Number*

Person/Company that collected assessment*

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.