Application for ticket cancellation and refund

Application for ticket cancellation and refund l'assenger• passport': (full name aci sutcd ts the matt for refunsli fposspoet yeges'number as stated in the ticket So resmai I apply: to cancel the ticket: ( ancellation °: 0 s oluninsy K i ns °lunar. ; titudoegc the gime the ego:unity reload. tw et ft jht canctIlahcn, etc) Rrven ation code (pNW': TIKOMO Ticks number*: 628242174634 (6 Armen) i U mambas, 622 Bi Iln umber*: 546983244432417 t IS numbers) Date of tithe( purchase at the website': kali 14 2019 2i to refund the amount paid": CO to the hank cad used lot payment: S 0 I n (Indus:ate the lag 4 numbers of the card', O other way (in case the honk card used for ticket purchase is rue valid any more): (Siege the data required to return, for es hunk name. dewing) I hack accept the tams and conditions stated below and vet: to pay chagvs and fees for tic&ct camellation and refund stated by Belasia- fichrusian Airlines. I apply to deduct the requested fees and charges from the amount to he refunded. -Application for ticket cancellation and refund must he filled in by . passenger or his her prosy, if passenger is of full age and legally capable; passenger's legal representative (parents, nduptise paren“, guardians or curators). if passenger is minor or legally inc•pa bk. Relavia - litlarusian Airlines bean no reitionsibilits for passenger's. hisiser prow's or legal representative's decision (or ticket cancellation and refund; as well as for any disagreement that ntay arise begsren hinvber and the payer as a consequence of the decision taken. For ticket earcellation and felonsd the copies of the following documents mug be {stunted by fax • filled in application for ticket cancellation and retinal (all the fields marked with a's art mandatory): • passenger's passport Inflow Vogel a any abet iskrititisation document lifjpgporskengia :conies): - proxy's passport inflow page) or any other identification document togethe with the pisscnistr's letter of attorney (if the purrengrea prav applies); - legal representatives pompon Inhale page) or any other identification document together with the document that nano hisrher legal status (if Thrtjanauginssataraessi: - conlimmtion of the insalidity of the hank card used for ticket purchase (in case the Kink caul k not valid in the month when the refund is transferred). Barris —Belartmian Airlines has the right to request additional Information or documents to take a decision for ticket cancellation and refund. 1 be amount to be refunded it calculated utairding to the applied fare mks and for the cancelled ticket only. The refund will be eatfied seta in 2 business clan once all the necessary documents are received. Belavia Relarusian Airlines bean no responsibility for possible difference resulted front currency consenion or bank service charges for money refund. Die Application is filled in by': O passenger El passenger's prosy K passenger's legal it:rev:mai tc Contact phone number': Time*: 703! Dole*: s3* 21 2019r. Signatur usan Est If sou need any assistance when filline in the Application, plaw contact or twenty-fotr-hour Customer Support Service by phone * - required fields EFTA00314001