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Clipper Card Cancellation form 2026
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How to use or fill out Clipper Card Cancellation form with our platform
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- Click ‘Get Form’ to open the Clipper Card Cancellation form in the editor.
- Enter your 10-digit Clipper card serial number in the designated field at the top of the form.
- Fill out your contact information, ensuring it matches your card registration. Include your first name, middle initial, last name, billing address, and phone numbers.
- Indicate your reason for cancellation by checking all applicable boxes in the 'Reason for Cancellation' section.
- Provide your credit card details for the $5 processing fee. Ensure that the billing address matches what you provided earlier.
- Sign and date the form to authorize payment and agree to the terms stated.
- Include your Clipper card with this completed form and mail it to Clipper Customer Service at the specified address.
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Related links
Your ClipperCash funds can be refunded upon graduation, transferring or withdrawal from the university by completing a ClipperCash Refund Form.Read more
Only registered Clipper cards are available for refunds. Please contact Clipper Customer Service at 877.878.8883 for Clipper card or Tap and Ride refundRead more