Incident Details

What happened?(Required)

Incident date(Required)

What is covered?

Sickness or Death of the Renter as a result of Coronavirus
Sickness or Death of someone in the renter's Immediate Family as a result of Coronavirus
A Government-imposed travel ban in your home or destination location, implemented after the purchase of the Refund Program

What is not covered?

The fear of travel due to any perceived fear of contracting the virus

Document Uploads

If you have been given a passcode please enter it here

Please upload your receipt/booking confirmation(Required)

Drop files here or

Max. file size: 2 MB, Max. files: 5.

Please upload any other photos/documents which maybe useful

Drop files here or

Max. file size: 2 MB, Max. files: 5.

Please provide any additional information

Vehicle Hire Details

Booking/order/voucher number(Required)

Date vehicle hire purchased(Required)

Vehicle hire start date(Required)

Vehicle hire end date(Required)

Cost of vehicle rental(Required)

Your Details

First Name(Required)

Last Name(Required)

Address(Required)

Town/City(Required)

US States(Required)

Postcode/Zip(Required)

Country(Required)

Mobile Phone(Required)

Payment

Please ensure your email and mobile number are correct. Confirmed refunds will be paid via www.Revolut.com who will email you requesting your payment details.

Declaration

On clicking the 'Submit' button below you will be registering a refund request which we will process on behalf of the vehicle hire company.
If there are other persons on this booking you have the authority to submit a refund application on their behalf.
You shall provide any further information which may reasonably be requested
You understand that the making of a fraudulent or exaggerated refund application is a criminal offence and may leave you liable to prosecution.
You agree that we may contact you via email and SMS for the purposes of this refund application
You agree that your name and email address will be provided to Revolut.com for the sole reason of processing your refund

Hidden

Unique ID