Application For Annual Season Ticket Loan

Application for Annual Season Ticket Loan

Season Ticket Application Form

Surname : School/Service : First Name : Payroll Number : Title :

Name of station where travel British Rail YES/NO starts and ticket will be London Underground station YES/NO purchased : Station where travel ends :

Zones to be included (if part of your journey is to be made by bus): First day of travel: Last day of travel: Cost of ticket: £ I hereby request that this sum, paid for in the first instance by UEL, be treated as a loan to me to be recovered by deduction from my salary over 10/12 months (please delete as applicable).*

I understand that staff in the Payroll Section will advise me if the actual cost of the loan differs from the amount quoted above.

* Please note that if you do not express a choice, your season ticket loan will be deducted over 12 months. I agree to abide by the Conditions as set out above.

Signature : Date :

PAYROLL USE ONLY Payroll Number

Start Monthly Value (1) Monthly Value (2) End