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My test was cancelled by the Driver and Vehicle Standards Agency at short notice and I want to claim the amount shown. I understand that filling in this form does not guarantee that I will receive a refund.  \nYour signature:  \nData protection  \nWe collect, use and store your personal data so that we can assess eligibility for out-of-pocket expenses for a cancelled driving test.  \nWe may share your personal data if we have a lawful reason, for example, as part of a criminal investigation or to prevent fraud.  \nFind out more [at www.gov.uk/dvsa/privacy](at www.gov.uk/dvsa/privacy)  \n3  \nHelpline  \n0300 200 1122  \nDVSA (D) 964  \nFor official use only  \nReference number: Category:  \nCancellation reason: Amount recommended for payment:  \nGrade: Date:  \nCertified by: Name:  \nGrade: Date:  \nAuthorised by: Name:  \nPayment made: Name:  \nGrade: Date:  \nHelpline  \n0300 200 1122  \nDVSA (D) 964  \nWhat you need to do  \nFor help filling in this form, refer to the guidance notes.  \nFill in the form using guidance notes  \nMake sure you’ve signed it  \nMake sure you’ve given permission for DVSA to contact your instructor and employer  \nMake sure you’ve put your receipts/documents in the envelope, including receipts for travel expenses or vehicle hire, and a letter from your employer if you’re claiming for lost earnings (see the guidance notes)  \nPost it to DVSA  \nDVSA will consider your claim  \nDVSA will process your payment if your claim is successful  \nFor all theory tests:  \nDriver and Vehicle Standards Agency Customer Service Department  \nPO Box 1286  \nWarrington  \nWA1 9GN  \n0300 200 1188  \nFor all practical tests:  \nDriver and Vehicle Standards Agency PO Box 349  \nNewcastle-upon-Tyne NE12 2GN  \n0300 200 1122  \n You do not need to print this page or post it to us.  \nHelpline  \n0300 200 1122  \nDVSA (D) 964","cbCaicPWx1ZYgt4z","https://ap.wps.com/l/cbCaicPWx1ZYgt4z","pdf",142749,"English","# Section 1 - Your details\n# Section 2 - Instructor hourly rate (practical tests only)\n# Section 3 - Claim details\n# Section 4 - Candidate declaration\n# Data protection\n# For official use only\n# What you need to do","[{\"question\":\"What information must be filled in on Section 1?\",\"answer\":\"Provide your full name and address, plus contact details. You also need to fill in at least 2 of the 3 marked details, including the theory test certificate number and/or application reference number, along with test centre, test date, and test time.\"},{\"question\":\"What does Section 2 require for practical tests?\",\"answer\":\"Include the instructor hourly rate and arrange for your instructor or trainer to complete the section or send a receipt, as guided. You also confirm payment and your standard hourly rate, and the instructor signs and includes their instructor number.\"},{\"question\":\"Does submitting the form guarantee a refund?\",\"answer\":\"No. The declaration states that filling in the form does not guarantee you will receive a refund; DVSA will consider the claim and process payment only if the claim is successful.\"}]","Apply for out-of-pocket expenses for a cancelled driving test - Claim form | PDF",13]