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

Email address

Name of Account Holder (As it appears on card)

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 6 digits of the long card number

Last 4 digits of the long card number

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

Please attach any further information needed