Dependant Travel No Longer Required

This form should be used to notify RST where travel is no longer required for a dependant

* - 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 Details

Title

First Name*

Last Name*

Dependant Type

Date of Birth*

Card No*

Reason

Notes*

Card Cancellation

In order to cancel the passes from the record please attach a picture of the card(s) with the number/name still visible cut into 4.

Attach Picture

Declaration*

By checking this box:By submitting this form:

I confirm that all details provided are correct.
I request that no further Rail Staff Travel facilities will be issued for this dependant
I will return all cards and passes for this dependant to RST (by “signed for” delivery) to Rail Staff Travel, PO Box 80612, LONDON EC4P 4NH or cut them up into four so they cannot be used and attach a photo of them to this form or form XX46

Signed by Employee:

Date:

Form - Dependant Travel Not Required - XX24 - This form is not valid for use after 31/03/2025

Once completed save the form with a filename of “YourLastname_YourFirstname_XX24_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