CREDIT CARD PAYMENT VOUCHER:
Please charge my credit card for renewal of the enclosed Operators Licence/Drivers Certificate.
Applicant Name: (if the same as card holder
Address: please leave blank)
Please charge the full cost of $ to my credit card.
Expiry Date: Name on card:
Signature of cardholder:
PLEASE ENSURE YOUR CARD NUMBER IS QUOTED CORRECTLY. FAILURE TO PROVIDE THE CORRECT
DETAILS MAY RESULT IN YOUR APPLICATION BEING REFUSED.
Please attach to your application and send to: Roads & Traffic Authority, Tow Truck Licensing & Compliance, Locked
bag 5054, Parramatta NSW 2124
OFFICE USE ONLY:
APPROVED: YES / NO AUTHORISATION NUMBER
OFFICER: DATE: / /