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Vehicle Licence Refund Application Form
Entries marked with * are mandatory.
Your Details
Full Name *
(required)
Address *
(required)
Driver Licence Number.
Are you a registered company? *
(required)
Yes
No
Company Name *
(required)
Company Address *
(required)
Company Registration Number *
(required)
Licence Details
Did you purchase Vehicle Licences within Financial Year 2016/17? *
(required)
Yes
No
How many Vehicle Licences did you purchase within Financial Year 2016/17? Please note you may have had more than one vehicle licence within the year. *
(required)
acceptable values 1 to 9999
invalid integer.
Please list all the Vehicle Registration Numbers of all vehicles licensed within Financial Year 2016/17 *
(required)
Please list all the 4 digit Vehicle Licence Numbers issued to your vehicles within Financial Year 2016/17 *
(required)
Did you purchase Vehicle Licences within Financial Year 2018/19? *
(required)
Yes
No
How many Vehicle Licences did you purchase within Financial Year 2018/19? Please note you may have had more than one vehicle licence within the year. *
(required)
acceptable values 1 to 9999
invalid integer.
Please list all the Vehicle Registration Numbers of all vehicles licensed within Financial Year 2018/19 *
(required)
Please list all the 4 digit Vehicle Licence Numbers issued to your vehicles within Financial Year 2018/19 *
(required)
Did you purchase Vehicle Licences within Financial Year 2019/20? *
(required)
Yes
No
How many Vehicle Licences did you purchase within Financial Year 2019/20? Please note you may have had more than one vehicle licence within the year. *
(required)
acceptable values 1 to 9999
invalid integer.
Please list all the Vehicle Registration Numbers of all vehicles licensed within Financial Year 2019/20 *
(required)
Please list all the 4 digit Vehicle Licence Numbers issued to your vehicles within Financial Year 2019/20 *
(required)
Did you purchase Vehicle Licences within Financial Year 2020/21? *
(required)
Yes
No
How many Vehicle Licences did you purchase within Financial Year 2020/21? Please note you may have had more than one vehicle licence within the year. *
(required)
acceptable values 1 to 9999
invalid integer.
Please list all the Vehicle Registration Numbers of all vehicles licensed within Financial Year 2020/21 *
(required)
Please list all the 4 digit Vehicle Licence Numbers issued to your vehicles within Financial Year 2020/21 *
(required)
Did you purchase Vehicle Licences within Financial Year 2021/22? *
(required)
Yes
No
How many Vehicle Licences did you purchase within Financial Year 2021/22? Please note you may have had more than one vehicle licence within the year. *
(required)
acceptable values 1 to 9999
invalid integer.
Please list all the Vehicle Registration Numbers of all vehicles licensed within Financial Year 2021/22 *
(required)
Please list all the 4 digit Vehicle Licence Numbers issued to your vehicles within Financial Year 2021/22 *
(required)
Were any of the above vehicles transferred to a new keeper? *
(required)
Yes
No
Please provide the Vehicle Registration Numbers that were transferred and the dates of transfer *
(required)
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