432501-03.pdf 1 30/11/2015 12:43 If your London Midland journey is delayed by 30 minutes or more, we think you ought to be compensated, whether it’s our fault or not. ‘Delay Repay' is a scheme to help you claim compensation simply and quickly; just complete this form and we'll send you the appropriate compensation in National Rail travel vouchers which can be used as payment for (or part payment) towards any National Rail ticket, including season tickets. Delay Repay compensation issued for journeys after 19 July 2015 will be subject to the new National Rail Conditions of Carriage. This means that London Midland issued National Rail travel vouchers can be exchanged for cash at any London Midland manned ticket office. If your compensation is over £30 and you won't be able to use National Rail travel vouchers, you can request a cheque. If you prefer to purchase your tickets online and have an account with London Midland you can request for compensation to be added directly to your London Midland account. Delays of 30-59 minutes: 50% of single ticket price 25% of return ticket price Delays of 60-119 minutes: 100% of single ticket price 50% of return ticket price Delays of 120 minutes or more: 100% of single ticket price 100% of return ticket price If you are a season ticket holder (including nNetwork and nTrain season tickets within the West Midlands area), you are entitled to the same scale of compensation, based on the proportional daily cost of your ticket. For more details, please pick up a copy of the London Midland Passenger’s Charter leaflet from any of our manned stations or view it online at www.londonmidland.com. The total compensation you can claim is capped: • For single/return ticket holders the compensation available is capped at 100% of the price of the ticket(s) purchased for that journey. • For season ticket holders, compensation is calculated on a proportional basis (as per our Passenger’s Charter), and is capped at 200% of this proportion of the face value of the ticket per day, which will usually equate to two journeys per day. You can only claim for either a journey you caught that was delayed or the first train you intended to catch that was cancelled. In simple terms, this means: • If the 7.30am was delayed by thirty minutes but you arrived at the station to catch the 8.15am train that was on time, you couldn’t get the delayed 7.30am train and claim for the 30 minute delay. Please fill in the details overleaf in BLOCK CAPITALS and return your form in the freepost envelope provided. If you wish to send it recorded delivery please send to: Customer Relations London Midland PO BOX 4323 Birmingham B2 4JB Call our customer relations team on 0344 811 0133 (calls are charged at local rate from a BT landline; charges from other operators and mobile phones vary). Claims need to be submitted within 28 days of the delay. Please include your original ticket, a ticket receipt or copy of your season ticket to prevent any unnecessary delay in processing your claim. 1. Personal details Initials Title Surname Address Town County Postcode Telephone number Email address 2. Ticket details Non Season ticket holders Single Return Season ticket holders 7 day 1 month 12 month Start date of season ticket (dd/mm/yy) Expiry date of season ticket (dd/mm/yy) Photocard number Other / / / / Season ticket holders Please attach a copy of your season ticket here Smartcard number Ticket price £ Non Season ticket holders Please attach your original ticket here, multiple tickets can be attached to the back of the form. Please avoid using staples. . 3. Journey details Date of travel (dd/mm/yy) / / From To Scheduled departure time (24 hrs) . Scheduled arrival time (24 hrs) Length of delay 30-59 mins 60-119 mins 4. Reason for claim Train cancelled Train delayed Ticket(s) unused Other 120+ mins First class declassified If you would like to be kept up to date with useful information from London Midland, please tick here How would you prefer to receive information? By post By email No preference London Midland will not pass your details to another organisation for marketing purposes at any time. .