QAS Data Check

Please only complete this form if you have received a recent letter from RST requesting
confirmation of your address details for the purposes of the Staff Travel Card Renewal.

* - Mandatory Field

Employee details

Title*

First Name*

Last Name*

NI Number*

Date of Birth*

Address 1*

Address 2

Town*

County

Postcode*

Home Phone

Mobile No

Email*

STC No

Card Required?

Notes

Spouse/Partner Details

Title

First Name

Last Name

Spouse/Partner Relationship

Date of Birth

Card Required?

STC No

Notes

Declaration*

By checking this box:By submitting this form:

I confirm that all details provided are correct.
I request that Rail Staff Travel use the above address and contact details
I understand that I am responsible for the correct use of my (and any dependant's) rail staff travel facilities and understand that such use is subject to the Conditions of Issue and Use which can be found at www.raildeliverygroup.com/rst/conditions-of-issue-and-use.
I further understand that Rail Staff Travel’s privacy information is available online at www.raildeliverygroup.com/rst/rst-privacy and that I have read it and have made my dependant(s) aware of it.
If I am in any doubt about eligibility, I understand that I MUST check and that any attempt to obtain or use rail staff travel facilities fraudulently may result in disciplinary action and/or legal proceedings and/or permanent withdrawal of all rail staff travel facilities for myself and all of my dependants.

Signed by Employee:

Date:

Form - Data Check - XX22 - This form is not valid for use after 31/03/2021

Once completed save the form with a filename of “YourLastname_YourFirstname_XX22_ddmmyyyy” – where ddmmyyyy is the date that you send the form to RST). Then submit via email to rst@raildeliverygroup.com