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AT HOP Card Cancellation Form 2026
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How to use or fill out the AT HOP card cancellation form online
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering your AT HOP Card Holder Name in the designated field. Ensure that this matches the registered details on AT.govt.nz/athop.
- Next, input your AT HOP Card Number accurately. This is crucial for processing your refund.
- Fill in your Street Address or PO Box, followed by your Suburb and City. These details help verify your identity.
- Provide a valid Phone Number and Email Address for any follow-up communication regarding your application.
- In the Bank Account Details section, enter the name of the bank account holder. If this differs from you, specify the relationship.
- Complete the Account Number fields with precision, ensuring all segments are filled correctly.
- Sign in the Declaration section to acknowledge surrendering your card and understanding the terms of use.
- Attach your AT HOP card with the number visible before submitting the form either by post or at an AT Customer Service Centre.
Start filling out your form online today for free and streamline your refund process!
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Related links
You asked us to cancel or suspend your enrollment in the Federal Employees Health Benefits Program (FEHBP). You may also fax the completed form to 202-606-1640
To sign up or cancel: Log in to Workday Select Benefits and Pay from the left-hand menu. Replacement policies and fees may apply through TriMet/Hop.