Application to have a priv discount set on an Oyster Card at a London Underground station

* - 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

Who I am applying for the priv discount for You must provide the Oyster card number for each person who you want the priv discount for. If you don’t we will reject your application.

Holder	Name	Oyster card number	Date of Birth
Employee
Spouse/Partner
Child Dependant
Child Dependant
Child Dependant
Child Dependant

Declaration*

By checking this box:By submitting this form:

I confirm that all details provided are correct and the Oyster cards mentioned above are all registered online with TfL.
I understand that if an incorrect discount is set or I am no longer eligible for the discount, TfL will remove the discount from my Oyster card.
I understand that I am responsible for the correct use of my (and any dependant's) rail staff travel facilities and understand that such use is subject to the Conditions of Issue and Use.
I understand that Rail Staff Travel’s privacy information is available online and that I have read it and have made my dependant(s) aware of 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, legal proceedings and permanent withdrawal of all rail staff travel facilities for myself and all of my dependants.

Signed by Employee:

Date:

Form - TfL Priv Oyster - XX19 - This form is not valid for use after 30/06/2027

Once completed save the form with a filename of “YourLastname_Your Firstname_XX19_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