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Blue Badge discount card

 
Please note: The fields marked * must be completed.
 
You have the right of access to the personal information that the Council holds about you. Should you wish to view this information, please contact the Data Protection Officer on telephone 01372 732000 or write to: Data Protection Officer, Epsom & Ewell Borough Council, Town Hall, The Parade, Epsom, Surrey, KT18 5BY.
 
(A full copy of your completed application will be sent to this address as confirmation of receipt)

 
 
 
 
 
 
 

Blue badge Expiry Date 

Blue Badge scan/photo: You must provide colour image files showing the front and back of your Blue Badge. Black and white images are not acceptable and may delay your application. If your images are of an unsuitable quality it may delay your application. Ideally images should be in landscape format and orientated the correct way up.
 
 
Images attached?

Your Details

Please complete your contact details in case we need further information to follow up this report.
 
 
 
 
 
 
 
 

Please enter a valid email address, e.g. contactus@epsom-ewell.gov.uk

 
 
 
 

Data Protection

Any information you provide will be used by us for the purpose of dealing with this report and will not be disclosed to the public. This information may be provided to organisation working on our behalf to rectify the problem.
 

Declaration

I confirm that to the best of my knowledge and belief the information I have given is true.
 

Blue Badge discount card: Terms and Conditions of Use
  • The Blue Badge discount card cannot be used in conjunction with any other concessionary or promotional parking charges
  • Blue Badge discount cards may only be used when the Blue Badge holder is present in the vehicle
  • Blue Badge discount cards are not transferable
  • The Council reserves the right to render invalid any card where there is evidence of fraudulent use
  • Parking charges, and the applicable concessionary rate, may be varied from time to time.
  • The opening hours of Hook Road car park will remain the same, ie Monday to Saturday, 0700 hours to 2000 hours. Closed on Sundays and Bank Holidays.

Lost cards
There is no charge for the issue of a Blue Badge discount card but there will be a non-refundable £10 charge to replace it if it is lost. A lost card should be reported immediately to Customer Services at the Town Hall to ensure that it is deactivated straight away. Any credit remaining on the card from the point of notification will be transferred to the new card.


I have read, understood and will comply with the above terms and conditions. *
I have read, understood and will comply with the above terms and conditions.

In order to process your form, you will need to agree to the Terms and Conditions.
 
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