Refund Details Form

Please complete all fields and provide as much detail as you can. Refunds can take up to 14 days to process due to banks internal processes.

Please note that all data inputted after the Unpaid Toll Charge Notice (UTCN) refund has been processed will be deleted in accordance with GDPR regulations.

Name

Business Name (if applicable)

Email address

Name of the registered bank account holder (if a business, please include the business name)

Vehicle Registration Number

Bank Account Number (The 8 digit number NOT your long card number).

Sort Code

Amount Agreed (This will be verified by the refunding agent).

First 8 digits of the long card number (Same card used as the original payment)

Last 4 digits of the long card number (Same card used as the original payment)

Is this the original card used to make payment now expired or unknown?
If so, please tick this box.
(We can only process refunds to the card that originally made the payment. If this is now expired, we will process a BACS payment after the necessary security checks. Please be aware this may take a little longer).

How did you originally pay?
WebsiteMobile AppOver the PhonePayPoint

What is the refund for? (E.g., UTCN refund, Pre-Paid account refund, debt collection agency refund etc.)

Pre-Paid Account Number (if applicable)

UTCN Number (Beginning with "TT") (if applicable)

Which agent authorised your refund? (if known)

If this is a Unpaid Toll Charge Notice (UTCN) refund, please state the time and date you paid the UTCN.
Date

Time

If your refund was agreed by email or letter, please attach evidence here. This will help the refunding agent verify your refund.