In the court of ________________

____________ Vs. ____________

Claim Petition 

Application for Refund of _________ charges i.e. Rs. ________/- lying deposited under account No. _______ dated ____________

Respectfully Showeth:

1-    That the above case is _________ in this Hon’ble court and is fixed for____________.

2-    That the applicant deposited the diet money of Rs. __________/- for the ___________on__________. The _________ was not effected in the _________.

3-    That now the applicant wants to withdraw the said amount from this Hon’ble court.

It is, therefore, prayed that the publication amount of Rs. ________/- may kindly be ordered to be refunded to the applicant/plaintiff.

Dated___________                                                                   Applicant/plaintiff

Through counsel

____________ Advocate_________