Public Transport Mdina Road, Qormi QRM 9010, Malta publictransport.com.mt Tallinja Card Registration Form

The Tallinja Card is a personalised transport card used on the public transport network in Malta and Gozo. Your photo and name will be printed on your card (except in the case of Child cards). The Tallinja Card may be topped up with credit online, using the Tallinja App, over the phone, at any of the sales outlets of Malta Public Transport or at any MaltaPost office. The form must be dropped off at any ticket booth together with all the required documents.

1. Name*

2. Surname*

3. Maltese Identity Card / Residence card / Passport / Other ID

Document Number* AFFIX PHOTO HERE 4. Email address

5. Date of birth* dd / mm / yyyy 00 / 00 / 0000

6. Mobile number*

7. Landline 8. Photo (Not applicable to children between 4 & 10 years, both included)

9. Address: House Name*

Street*

Town*

Postcode* Country*

10. Are you a holder of a Maltese EU Disability card issued by the Commission for the Rights of Persons with YES NO Disability (CRPD)?* ** If yes, please provide your Maltese EU Disability Card number: I give my consent to Malta Public Transport to access, process and share my personal information from YES NO CRPD to verify and confirm that I am a holder of a Maltese EU Disability card. This is required and necessary for the issuing of my Concession Tallinja Card, and for renewing it on a yearly basis. ** 11. Are you a student attending a full-time course with a recognised educational institution in Malta for a YES NO minimum of 3 months?* ** If yes, please provide the name of the educational institution: Please attach proof of attendance if aged 17 and above and applying for a Student Card. I give my consent to Malta Public Transport to access, process and share my personal information with the YES NO relevant educational institution to verify and confirm that I am a student attending a full-time course with a recognised educational institution in Malta for a minimum of 3 months. This is required and necessary for ** the issuing of my Student Tallinja Card, and for renewing it on a yearly basis. 12. Do you give your consent to Malta Public Transport to access, process and share your personal YES NO information from the National Identity Card Database or the Driving Licence Database, on behalf of Transport Malta, for the purpose of issuing your Tallinja Card? (Only applicable to holders of Maltese electronic Identity ** Card - eID card.)* If you answered YES to the above AND you have a Maltese electronic Identity Card, please provide the Document reference Number, which is found on the back of your eID card: 13. Nationality (Data about your Nationality is being collected for statistical purposes only)

Date Signature (If under 16 years, name & signature of parent/guardian is required) For office use only Items marked (*) must be filled in. Check List 1. Attach a copy of your identification document. Copy both sides where required. 2. Attach proof of attendance of a course of a minimum of 3 months if older than 17 years and applying for a Student card. 3. Attach a passport photo. See below for passport photo requirements. 4. Sections 10, 11, and 12 of this application must also be filled in. Notes 1. Children up to 4 years travel for free and do not need a tallinja card. 2. The Child card is available for Children between 4 and 10 years (both included). 3. The Student card is available for persons between 11 and 16 years (both included) and to students attending a full time course of a minimum of 3 months. 4. The Adult card is available for persons older than 17 years. 5. The Concession card is available for holders of a Maltese Identity Card Kartanzjan / 60+ or Maltese EU Disability Card issued by the Commission for the Rights of Persons with Disability (CRPD). 6. The Gozo card is available to Gozo residents. 7. Different cards and fares are available for Children, Students, Adults, Kartanzjan / 60+ ID Card Holders, Maltese EU Disability Card Holders and Gozo Residents. Passport Photo Requirements Your passport photo must follow these requirements: 1. Must be in colour 2. Must be printed on matt or glossy photo quality paper 3. Must fit in the box labelled (8) in the ormf 4. Must be taken within the last 6 months to reflect your current appearance 5. Must be taken in front of a plain white background 6. Must be taken directly facing the camera 7. Must be taken with a neutral facial expression or a natural smile and with both eyes open 8. There must be no other person or object in the photo with you Terms and Conditions 1. The Tallinja Card is a plastic intelligent card which electronically stores pay-as-you-go Travel Credit and which may be used to pay any Malta Public Transport bus fare in Malta and Gozo. 2. The Tallinja Card needs to be topped up with Travel Credit by the Cardholder and the equivalent cost of the fare will be deducted fromthe Card’s credit every time the Cardholder uses the Card. 3. By touching the Tallinja Card on the reader, the Cardholder is consenting to the Fare being charged to the Tallinja Card’s account. If there is no remaining credit on the Tallinja Card, the Tallinja Card cannot be used for any further journeys until it is ‘Topped Up’, this subject to an ‘Emergency Credit’ facility. The Tallinja Card will feature: · The Cardholders name and surname for identification purposes · A photo of the Cardholder (except for Child Cards) · Colour-coded cards according to the Cardholders category · A number of discounted Fare options for special categories including Children, Students, Adults, Kartanzjan/60+ Maltese Identity Card Holders, Holders of Maltese EU Disability Cards issued by CRPD and Gozo Residents 4. When registering for a Tallinja Card, the following charges will apply: Card Registration Fee: €10.00 Postage Fee: €2.26 for local deliveries €8.00 for overseas deliveries Minimum Top Up: €20.00 for Student, Adult and Gozo cards €10.00 for Child and Concession cards Fees are with effect from 1 June 2019.

The full set of Terms and Conditions of the tallinja card are available on publictransport.com.mt.

document number: 001/19 V5