Please complete all sections of this form. Once submitted, please allow up to 20 business days for your refund to be processed.
Australian bank account details
Please provide the Claimant's bank account details here. This information will be used to credit the refundable balance on your Opal card back to your bank account.
Refunds can only be deposited into an Australian bank account.
By submitting this form, you:
1.
represent and warrant that the information provided in this form is true, accurate, complete and up to date;
3.
agree to destroy and cease using the Opal Card;
4.
agree to provide your bank account details for the purpose of receiving the refund;
5.
accept that the Opal card will be cancelled;
6.
accept that TfNSW will collect and handle your personal information provided in this form (including by disclosing such information to third parties) in order to fulfil your request to cancel the Opal card and provide you with a refund, in accordance with the
privacy policy;
7.
agree to compensate TfNSW for any loss or liability TfNSW incurs if this declaration, or any of the information provided by you in this form, is incorrect; and
8.
release TfNSW, to the full extent permitted by law, from all liability in relation to the Opal card and its Opal card balance and in relation to this refund form, upon submission of this form.
I accept the above terms and conditions when submitting this form *