LOST AND DAMAGED/DEFACED REPLACEMENT FORM –

* - 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*

Work Email

Reason for Replacement

Replacement Reason:*

EVIDENCE SUPPLIED (DAMAGED CARDS ONLY)

Damaged - For damaged cards a clear colour image of the card (front and back) must be attached.

Damaged Card Images

Delivery

If you submit the payment through your RST Online account before 12.30pm on a business day, we will post your paper card(s) to you on the same day by 1st class post. Smartcards are sent separately from one of our suppliers so you need to allow a minimum of five working days for them to arrive.
If any replacements have not arrived within two weeks of you making payment, you should email us at rst@raildeliverygroup.com stating your name and address and which cards/passes have not arrived.

Payment

Payment Method *

You must make payment by logging into your RST Online account. You will need to click on ‘Your Account’ and go to the ‘Ad-Hoc Payments’ section on the lefthand side. If you don’t have an account, we will email you details of how to create one. We will confirm when you are able to make the payment and then once payment has been received your card(s) will be issued and a confirmation email will be sent out.

Replacement Information

Where cards contain boxes, then the replacement number of boxes will be issued on a pro-rata basis calculated in accordance with the card’s terms and conditions. (Unless the card is damaged and we can see the number of boxes that have been used)
The current replacement fees are on the Useful Information page of the RST website www.raildeliverygroup.com/rst/useful-information.
Payment must be made by Credit/Debit Card. AMEX is not accepted.
Please ensure you take the time to select the correct product and use the guide in the link provided to help you to avoid the incorrect product being issued or a delay to your request.
We will process your application and create the payment request in your RST Online account within one business day.

Declaration*

By checking this box:By submitting this form:

I confirm that all details provided are correct.
I understand that I am responsible for the correct use of my 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.
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 - Lost and Damaged XX35 - This form is not valid for use after 31/03/2025

Once completed save the form with a filename of “YourLastname_Your Firstname_XX35_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