This form is for people who were convicted of a railway fare offence (Regulation of Railways Act 1889, section 5) through the Single Justice Procedure (SJP). Circle Vision Foundation (registered charity 1209727) can help you apply to have the conviction declared void and set aside, and seek a refund of any fine and costs you paid. This is a free charitable service and does not guarantee an outcome.

I authorise Circle Vision Foundation (registered charity 1209727) and its caseworkers to: (a) correspond with HMCTS, the magistrates' court and the prosecuting train company about this matter on my behalf; (b) request and receive copies of my case papers and personal data; and (c) prepare and submit, in my name, a request or application to have my conviction declared void and set aside and to seek a refund. I understand this is a free charitable service, that an outcome is not guaranteed, and that I can withdraw this authority in writing at any time.

Circle Vision Foundation will process the personal data and criminal-offence information in this form only to help with your case, in line with UK GDPR and the Data Protection Act 2018 and our privacy policy. We keep it secure and share it only with the court, HMCTS and the train company as needed. See our privacy policy at https://www.circle-vision.org/privacy-policy/

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