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ADI
Refund Request
Customer name
*
First
Last
Customer post code
*
Date first requested by customer
*
DD slash MM slash YYYY
Final decision date
*
DD slash MM slash YYYY
10 working days from first request
P number
*
Course duration
*
6 hours
12 hours
18 hours
24 hours
30 hours
36 hours
42 hours
48 hours
Transmission
*
Automatic
Manual
Booking method
*
Online
Telephone
Was a theory test booked
*
Yes
No
Theory status
*
Cancelled
Taken and passed
Taken and failed
Is the driving test booked
*
Yes
No
Driving test status
*
Locked
Taken and passed
Taken and failed
Cancelled
Before cancelling this test, check with allocation if the test can be reallocated.
Was the fast track booked
*
Yes
No
Did the course start
*
No
Yes
How many hours were complete
*
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
Has the ADI been paid for the course
*
Yes
No
How much was the ADI paid
*
Has the ADI returned any of the course fee
*
Yes
No
How much has the ADI returned
*
ADI name
*
First
Last
Deposit amount
*
Balance amount paid
*
How to return payment to customer
*
Bank transfer
Return to card
Cheque
Total amount to refund
*
Name on account
First
Last
Sort code
*
Account umber
*
Notes
*
Describe the reason for this refund
Completed by
*
Cameron
Declan
Holly
Kieran
Macie
Mark
Mike
Nicola
Sion
Stephanie
Ryan
Course coordinator
*
Cameron
Declan
Holly
Kieran
Macie
Mark
Mike
Nicola
Sion
Stephanie
Ryan