Refund Request Form Refund Request ApplicationWe require the following additional information and documents to proceed with your refund request.Your Name(Required) First Last Your Address(Required) Street Address Address Line 2 City Postal Code Your Email Address(Required) Email Address Confirm Email Address Your Phone(Required)Who requested you to complete the Program?(Required)Court HouseSolicitorRoads & Maritime ServicesSelf – ReferredSelect Court House(Required)Albion Park Court HouseAlbury Court HouseArmidale Court HouseBallina Court HouseBalmain Court HouseBalranald Court HouseBankstown Court HouseBatemans Bay Court HouseBathurst Court HouseBega Court HouseBellingen Court HouseBelmont Court HouseBidura Children's Court – GlebeBlacktown Court HouseBlayney Court HouseBoggabilla Court HouseBombala Court HouseBourke Court HouseBraidwood Court HouseBrewarrina Court HouseBroken Hill Court HouseBurwood Court HouseByron Bay Court HouseCamden Court HouseCampbelltown Court HouseCasino Court HouseCessnock Court HouseChildren's Court of ParramattaCobar Court HouseCoffs Harbour Court HouseCondobolin Court HouseCooma Court HouseCoonabarabran Court HouseCoonamble Court HouseCootamundra Court HouseCorowa Court HouseCowra Court HouseCrookwell Court HouseDeniliquin Court HouseDowning Centre SydneyDubbo Court HouseDunedoo Court HouseDungog Court HouseEast Maitland Court HouseEden Court HouseFairfield Court HouseFinley Court HouseForbes Court HouseForster Court HouseGilgandra Court HouseGlen Innes Court HouseGloucester Court HouseGosford Court HouseGoulburn Court HouseGrafton Court HouseGrenfell Court HouseGriffith Court HouseGulgong Court HouseGundagai Court HouseGunnedah Court HouseHay Court HouseHillston Court HouseHolbrook Court HouseHornsby Court HouseInverell Court HouseJunee Court HouseKatoomba Court HouseKempsey Court HouseKiama Court HouseKogarah Court HouseKurri Kurri Court HouseKyogle Court HouseLake Cargelligo Court HouseLeeton Court HouseLightning Ridge Court HouseLismore Court HouseLithgow Court HouseLiverpool Court HouseLockhart Court HouseMacksville Court HouseMaclean Court HouseMaitland Court HouseManilla Court HouseManly Court HouseMilton Court HouseMoama Court HouseMoree Court HouseMoruya Court HouseMoss Vale Court HouseMount Druitt Court HouseMudgee Court HouseMullumbimby Court HouseMungindi Court HouseMurrurundi Court HouseMurwillumbah Court HouseMuswellbrook Court HouseNarooma Court HouseNarrabri Court HouseNarrandera Court HouseNarromine Court HouseNewcastle Court HouseNewtown Court HouseNorth Sydney Court HouseNowra Court HouseNyngan Court HouseOberon Court HouseOrange Court HouseParkes Court HouseParramatta Court HousePeak Hill Court HousePenrith Court HousePicton Court HousePort Kembla Court HousePort Macquarie Court HouseQueanbeyan Court HouseQuirindi Court HouseRaymond Terrace Court HouseRichmond Court HouseRyde Court HouseRylstone Court HouseScone Court HouseSingleton Court HouseSutherland Court HouseTamworth Court HouseTaree Court HouseTemora Court HouseTenterfield Court HouseToronto Court HouseTumbarumba Court HouseTumut Court HouseTweed Heads Court HouseWagga Wagga Court HouseWalcha Court HouseWalgett Court HouseWarialda Court HouseWarren Court HouseWauchope Court HouseWaverley Court HouseWee Waa Court HouseWellington Court HouseWentworth Court HouseWest Wyalong Court HouseWilcannia Court HouseWindsor Court HouseWollongong Court HouseWoy Woy Court HouseWyong Court HouseYass Court HouseYoung Court HouseOther/ Not Attending CourtSolicitor Name(Required) Solicitor Email(Required) What was your offence? (select all)(Required) Low Range PCA Mid Range PCA High Range PCA Special Range PCA Prescribed Illicit drug in oral fluid/blood/urine Speeding 0 to 10kph Speeding 10 to 20kph Speeding 20 to 30kph Speeding 30 to 45kph Speeding Above 45kph Drive whilst Unlicensed Drive whilst Disqualified Drive whilst Suspended Negligent Driving Dangerous Driving Promote Street Racing ITOP Education ( Select ONLY if you have received a letter from RMS to attend a Driver Education Course) Court Ordered Condition (including Section 10 & Good behavior Bond) Other Reasons For RefundPlease let us know what's on your mind. What was your intention for attending the program?(Required)How have you personally benefited from attending the program? If not, why not?(Required)Did you receive the legal outcome you were aiming for?(Required)What was the outcome you were aiming for? What was the outcome you received?(Required)EvidencePlease upload your legal documents as evidence of you following the correct procedures.Supporting Documentation(Required)Max. file size: 128 MB.Upload a copy of your TfNSW or RMS requirement to attend Letter(Required)Max. file size: 128 MB.
