Refund Web Registration
ONLINE TICKET REFUND REGISTRATION FORM
 
PNR Number *
Date of Journey *    Click to Select Journey Date
TICKET DETAIL
Train No. Train Name
From To
Boarding Point Reservation Upto
Date of Journey Class
Ticket No. Ticket Type
Date of Booking Total ticket fare(Rs.)
Transaction Id Pass/Warrent No.
REFUND DETAIL
Refund Claimed * Ticket will be deposited at Station *   Stn. Help
E.F.T/G.C Submitted    E.F.T/G.C ? E.F.T/G.C No.
E.F.T/G.C Date    Click to Select E.F.T/G.C date E.F.T Amount
PASSENGER DETAIL REFUND DETAIL
Sr.
No.
Name * Age Conc.
Code
Gen-
der
Booking
Status
Current
Status
Quota Refund Reason *
AC Failure/Lower Class Travel/
Actual Journey Travelled between stations:
1.
2.
3.
4.
5.
6.
CLAIMANT DETAILS
Applicant Name *
Postal Address *
City/Town * Telephone Number     
State/U.T * Mobile Number
Pincode Email Id
APPLICANT BANK ACCOUNT DETAILS
(Please furnish your Bank Account detail. Refundable amount, if approved, will be credited to this account.)
Account Type Account Number
Bank Name    
MICR Code IFSC Code
Branch Name City
District State

******Enter Verification Code******



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