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Application for ticket cancellation and refund l'assenger• passport': (full name aci sutcd ts the matt for refunsli fposspoet yeges'number as stated in the ticket So resmai I apply: to cancel the ticket: ( ancellation °: 0 s oluninsy K i ns °lunar. ; titudoegc the gime the ego:unity reload. tw et ft jht canctIlahcn, etc) Rrven ation code (pNW': TIKOMO Ticks number*: 628242174634 (6 Armen) i U mambas, 622 Bi Iln umber*: 546983244432417 t IS numbers) Date of tithe( purchase at the website': kali 14 2019 2i to refund the amount paid": CO to the hank cad used lot payment: S 0 I n (Indus:ate the lag 4 numbers of the card', O other way (in case the honk card used for ticket purchase is rue valid any more): (Siege the data required to return, for es hunk name. dewing) I hack accept the tams and conditions stated below and vet: to pay chagvs and fees for tic&ct camellation and refund stated by Belasia- fichrusian Airlines. I apply to deduct the requested fees and charges from the amount to he refunded. -Application for ticket cancellation and refund must he filled in by . passenger or his her prosy, if passenger is of full age and legally capable; passenger's legal representative (parents, nduptise paren“, guardians or curators). if passenger is minor or legally inc•pa bk. Relavia - litlarusian Airlines bean no reitionsibilits for passenger's. hisiser prow's or legal representative's decision (or ticket cancellation and refund; as well as for any disagreement that ntay arise begsren hinvber and the payer as a consequence of the decision taken. For ticket earcellation and felonsd the copies of the following documents mug be {stunted by fax • filled in application for ticket cancellation and retinal (all the fields marked with a's art mandatory): • passenger's passport Inflow Vogel a any abet iskrititisation document lifjpgporskengia :conies): - proxy's passport inflow page) or any other identification document togethe with the pisscnistr's l

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