DEPENDANT - CHANGE OF NAME

* - 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*

Dependant New Name and Documentary Proof of Change

Title*

First Name*

Last Name*

Dependant Relationship

Attachment Type

Other Attached Document

Change of Name Document*

Dependant Former Name

Former First Name*

Former Last Name*

Dependant Passport Name (Only complete if different from Dependant's New Details)

Passport First Name

Passport Last Name

Additional Information

Any documents supplied that are not in English must be accompanied by an official translation
All cards and passes must be returned to RST (by "signed for" delivery) - to Rail Staff Travel, PO Box 72071, LONDON EC1P 1JD - for reissue in your dependants new name

International travel: your dependant's FIP card must match their passport name, so only send this for updating if they are also changing their passport
Leisure travel: please return all cards and passes to RST (by “signed for” delivery) for reissue in their new name.

Declaration*

By checking this box:By submitting this form:

I confirm that all details provided are correct.
I request that my dependant's name is changed as stated above and will return their current rail staff travel facilities by "signed for" delivery to be reissued.
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 - Dependant Name Change - XX26 - This form is not valid for use after 31/03/2021

Once completed save the form with a filename of “YourLastname_YourFirstname_XX26_ddmmyyyy” – where ddmmyyyy is the date that you send the form to RST). Then submit via email to rst@raildeliverygroup.com or your normal rail staff travel facilities contact point