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									                                            Newcastle University

                     Go North East BuzzFare Application – Employer Loan

To apply for an Annual BuzzFare ticket through the travel ticket loan scheme from your employer
please complete the following details and return this form together with form TP1 to: Paul Durkin, ESS,
1st floor Agriculture Building.
Annual Buzzfare Tickets will be dispatched without charge using Royal Mail First Class post to your
home address. A replacement ticket will be issued if lost or stolen although there is a fee for this
payable direct to Go North East.

BuzzFare tickets are valid for unlimited travel on all Go North East buses (except our night buses
which are numbered with an “N” prefix). For more information on the range of BuzzFare tickets
available visit www.simplygo.com and check out the BuzzFare pages.


Your Details                      Complete this section

First Name
Last Name
Home Address Line 1
Home Address Line 2
Home Address Line 3
Home Address Line 4
Post Code


Your Ticket                                    1 zone                         2 zone                       3 zone +

Colours of BuzzFare zones
required
When would you like your             1st
ticket to start:

Your Agreement
I hereby agree that I wish to participate in the BuzzFare Season Ticket Loan Scheme. By signing this
agreement I accept the scheme conditions set out above.


Signed: ________________________________                   Date: _______/__________/_______

Your Employers Agreement
I hereby agree that I have the authority to place ticket orders on behalf of my organisation and
authorise the above application by the above employee.


Signed: ________________________________                   Date: _______/__________/_______

Designation: _____________________________________________________

Refunds

Refunds are available on tickets which are no longer required subject to our standard “Refund and Replacement
Policy” which applies in all cases. Current prices and our refund and replacement policy are available on the
BuzzFare pages of our website www.simplygo.com.

IMPORTANT - USE OF YOUR OWN INFORMATION
Go North East will use the information you have provided on this application for the administration of its
BuzzFare Season Ticket Loan Scheme only. We will ensure that this and other personal information we hold
including electronic information held on computer will be stored securely. Access to information contained in this
application will be restricted to those involved in the administration of the scheme.
                                                                                          Form TP1

               UNIVERSITY OF NEWCASTLE UPON TYNE
        APPLICATION FOR ANNUAL TRAVEL TICKET LOAN SCHEME

Please complete ALL details below in BLOCK CAPITALS:

Title               ………………………………….. Personnel No                          ………………………………

Full Name           ………………………………….                    Job Title           ……………………………….

Date of Birth       ………………………………                      School/Service      ……………………………….

Home Address        ………………………………….
                      Ext. No.       ……………………………
                      E-mail address ……………………………….
…………………………………………………………………………………………………………….

_____________________________________________________________________

I hereby apply for a corporate travel loan and give authority below to deduct the
appropriate charge from my salary.

SALARY DEDUCTION AUTHORISATION

Signature       …………………………………                                     Date ………………………….

Amount          £………………………………..

If on fixed term contract, please indicate contract end date: ………………………..

Please select preferred payment method from options below


        One lump sum payment (deducted from salary)

        Monthly instalment (deducted from salary)

In the event of leaving the University, any outstanding balance on the travel loan will
be deducted from final salary.

This form should be returned with your discounted travel scheme application
form to: Estate Support Service, 1st floor Agriculture Building, Newcastle, NE1
7RU. INTO Staff should also return a copy to INTO HR Department

-------------------------------------------------------------------------------------------------------
OFFICE USE ONLY
                                                                  Commencement Date …………………

Travel card type:                                                 Renewal Date       …………………

                                                                  Cancel Date        …………………

								
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