Form 1519 TfL PAYG Oyster

RAIL STAFF TRAVEL LIMITED

APPLICATION FOR TRANSPORT for LONDON PRIVILEGE PAY AS YOU GO OYSTER CARD

SAFEGUARDED STAFF ONLY

·  One form per person

·  Employee details still needed even if application is for partner/spouse/child

·  If application is in respect of a partner/spouse, that person must also sign the form

·  If application is in respect of a child, just the employee should sign the form

Employee details
Title / Mr Ms Mrs Miss / NI No / Date of birth
First name / Last name
Home address
Post code
Tel No (mobile) / Email
Status / Active Retired Widow(er)
If application is in respect of a family member, give that person’s details
Title / Mr Ms Mrs Miss / Date of birth
First name / Last name
Dependancy (tick one): / Spouse Partner Child
Your chosen password for this new Oystercard
(ie only if you do not already have one registered )
Current ATOC Rail Staff Travel Card details / Prefix: Number:
CONFIRMATION BY THE EMPLOYEE
I hereby apply for a TfL PAYG Oyster Card. I understand that I am subject to the Conditions of Issue and Use which can be found at www.atoc.org/rst and to any other conditions imposed by Transport for London.
Signature of employee
Date
CONFIRMATION BY THE SPOUSE/PARTNER
I hereby apply for a TfL PAYG Oyster Card. I understand that I am subject to the Conditions of Issue and Use which can be found at www.atoc.org/rst and to any other conditions imposed by Transport for London.
Signature of spouse/partner
Date

Once completed (save electronically as “YourLastname_1519_YourNInumber”) submit via your normal travel facilities contact point.

RSTL Approved by: / Date
For issuing station use only: Oyster card No: Station NLC:

RAIL STAFF TRAVEL LIMITED (www.atoc.org/rst) is part of:

Issue date 1 January 2015