CREDIT CARD PAYMENT VOUCHER: Please charge my credit card for renewal of the enclosed Operators Licence/Drivers Certificate. Applicant Name: Address: Please charge the full cost of $
MASTERCARD VISACARD EFTPOS
(if the same as card holder please leave blank) to my credit card.
Expiry Date: Address: Signature of cardholder:
Name on card:
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: OFFICER: YES / NO AUTHORISATION NUMBER DATE: / /