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Clipper cancellation form

Clipper cancellation form 2025

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4.9 out of 5

46 votes

The document is a cancellation form for Clipper cards, detailing the process to cancel a card and request a refund for eligible transit cash value, parking value, and unused passes. It outlines the necessary steps, including providing personal information, reasons for cancellation, and payment details for a $5 processing fee. Refunds are subject to specific conditions and will be mailed within 30 days.

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Click ‘Get Form’ to open the clipper cancellation form in the editor.
Enter your Clipper Card Serial Number, which is a 10-digit number located on the back of your card.
Fill in your Cardholder Contact Information. Ensure that this matches your registered details, including your first name, last name, billing address, and phone numbers.
Indicate your Reason for Cancellation by checking all applicable boxes. Options include moving out of the area or dissatisfaction with the Clipper program.
Provide Payment Details and Credit Card Authorization. Enter your credit card type, number, security code, and expiration date to cover the $5 processing fee.
Sign and date the form to authorize payment and agree to the terms stated.
Submit the completed form along with your Clipper card by mailing it to Clipper Customer Service at the provided address.

Start filling out your clipper cancellation form online for free today!

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Versions	Form popularity	Fillable & printable
2018	4.9 Satisfied (46 Votes)
2013	4.6 Satisfied (39 Votes)
2012	4.7 Satisfied (61 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What to do if I lose my Clipper card?

What should I do if my card is lost or stolen? Log in to your Clipper account, select Report Lost or Stolen from the More Options menu, or. Call 877.878.8883 (TDD/TTY 711 or 800.735.2929)

Is Clipper refundable?

Clipper Refunds: Only registered Clipper cards, are available for refunds. Please contact Clipper Customer Service at 877.878. 8883 to request a refund without cancelling your card.

Can you cancel a Clipper card?

CANCELLATION INSTRUCTIONS All card cancellations require a $5 processing fee. If the balance on your card is less than $5, Clipper will not process your refund request or charge the $5 processing fee.

How do I cancel my Clipper card?

Log in to your Clipper account. Find your card and select Manage Autoload from the More Options menu. Your Autoload is now cancelled, but your online account will not reflect this until the next time you tag your card.

How do I transfer my Clipper card balance to another card?

To transfer your unused cash balance to a new card, you need to purchase a new adult Clipper card on your device and then call Clipper Customer Service at 877.878. 8883 to request a balance transfer.