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Request for a TER Grand Est solidarity card

ÿ First request ÿ Renewal

Applicant

Mrs ÿ Mr ÿ Name |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__ |__|__|__|__|__|__|__|__|__|__| First name |__|__|__|__|__|__|__|__|__|__|__|__|

__|__|__|__|__|__|__|__|__|__|__|__| __| Born on |__|__| |__|__| |__|__|__|__|

No. |__|__|__|__| Way |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| __|__|__|__|__|__|__|__|

(Additional address) |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__ |__|__|__|__|__|__|__|__|__|

Code postal |__|__|__|__|__| Commune |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|

* *
Landline |__|__|__|__|__|__|__|__|__|__| Cell phone |__|__|__|__|__|__|__|__|__|__|
*
@
E-mail |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| __|__|__|__|__|__|__|__|__|__|__|__|__|__|
Number of beneficiaries registered on the CMUC certificate: _______

Number of solidarity cards requested: _______ *Optional fields

1st beneficiary

Mrs ÿ Mr ÿ Name |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__ |__|__|__|__|__|__|__|__|__|__| First name |__|__|__|__|__|__|__|__|__|__|__|

__|__|__|__|__|__|__|__|__|__|__|__|__| __| Born on |__|__| |__|__| |__|__|__|__|

2nd beneficiary

Mrs ÿ Mr ÿ Name |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__ |__|__|__|__|__|__|__|__|__|__| First name |__|__|__|__|__|__|__|__|__|__|__|

__|__|__|__|__|__|__|__|__|__|__|__|__| __| Born on |__|__| |__|__| |__|__|__|__|

3rd beneficiary

Mrs ÿ Mr ÿ Name |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__ |__|__|__|__|__|__|__|__|__|__| First name |__|__|__|__|__|__|__|__|__|__|__|

__|__|__|__|__|__|__|__|__|__|__|__|__| __| Born on |__|__| |__|__| |__|__|__|__|

For more than 3 beneficiaries, use a second form.

I certify on my honor the accuracy of the information provided in this application.

I declare that I have read the general conditions of use appearing on the reverse and I undertake to comply with them.

Do it _______________________ has
__________________________ Signature of Applicant :

Elements to provide to obtain your solidarity card(s): - the attached form duly
completed and signed, - a photocopy of your valid
Complementary Universal Health Coverage (CMUC) certificate, - a photocopy of one side -back of a valid identity document for each beneficiary
appearing on this form (identity document which must include a photograph: identity card, passport, residence permit (resident card, residence certificate,
receipt noting the submission of an asylum application or a residence permit application)), - 1 recent color identity photo (imperative format 35 x 41 mm,
without retouching, on a neutral background, clearly highlighting the outline and details of the portrait, head front or
three-quarter view) per beneficiary, indicating their first and last name on the back.

The Solidarity Cards will be sent to your home within 15 days from the date of receipt of the request.

Return the complete file by post, in a closed envelope with sufficient postage to: Grand Est Solidarity Card Management Center - CS 23915 54029 NANCY
CEDEX.

Fcsolid06/17
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GENERAL CONDITIONS OF USE OF THE TER GRAND EST SOLIDAIRE CARD (as of September 1 , 2017)

OBJECT VI - INFORMATION RELATING TO PERSONAL DATA

This membership fixes, on the basis of the principles described below, the rules to be respected by the The data collected through the subscription form is mandatory, except email and telephone numbers which
parties in the context of the use, designated under the name “solidarity card”, as a support giving right to the are recommended.
reduction solidarity card on the TER perimeter of the Grand Est Region. The data is collected by SNCF Mobilités and is subject to automated processing, the purpose of which is the
Holding the solidarity card allows you to obtain transport tickets with an 80% reduction on the normal fare, in management of solidarity cards. They are intended for SNCF Mobilités.
second class, for all journeys. If the required fields are not completed, the subscription request cannot be processed.
The automated processing of personal information has been declared to the CNIL.
In accordance with the amended “Informatique et Libertés” law of January 6, 1978, any person affected by
the processing has:
APPLICATION OF THE GENERAL CONDITIONS OF USE
- a right of access, query and rectification which allows him, if necessary, to rectify, complete, update, lock or
In agreement with its organizing authority, SNCF Mobilités reserves the right to change these general delete personal data concerning him which are inaccurate, incomplete , ambiguous, out of date or whose
conditions of use with at least one month's notice. In this case, the new general conditions will be brought to collection, use, communication or conservation is prohibited;
the attention of customers on the SNCF Mobilités website.
- a right to object to the processing of this data, for legitimate reasons.
The nullity in whole or in part of one or more provisions of these T&Cs, under the terms of a legal or All of these rights can be exercised with SNCF Contact TER Grand Est - BP 10056 - 67067 STRAS-BOURG
regulatory provision or a court decision that has become definitive, does not result in the nullity of the other Cedex by post accompanied by a photocopy of the identity document.
provisions or of the part of the provision not vitiated by nullity. All customer data is kept for the duration of the contractual relationship, and at the end of it for two (2) years
for commercial and statistical purposes for customers and prospects.

I - THE SOLIDARITY CARD VII - INFORMATION AND COMPLAINTS

The card includes: Any information or complaint concerning the conditions of use or the monitoring of a sub-file
- A common front to the visual of the solidarity card
The solidarity card must be requested from Contact TER Grand Est - BP 10 056 - 67067 Strasbourg Cedex.
- A back which displays personal information in particular: surname, first name, identity photograph, card
number and expiry date.
This complaint must be made within two (2) months from the date of the facts justifying the complaint.

In the event of a justified complaint, the customer's situation is restored as quickly as possible, with both
II - THE HOLDER OF A SOLIDARITY CARD parties endeavoring, in any case, to find an amicable solution in the event of a dispute.
Under no circumstances can the issuer be held liable for non-performance or poor performance of their
The name “holder” indicates for these T&Cs the person registered on the solidarity card. services by carriers other than the issuer.
The solidarity card is nominative, strictly personal and its holder can only be a natural person. This card is
not transferable and cannot be used by a third party.
The holder must be over 4 years old on the date of application for the solidarity card. For unemancipated
VIII - DURATION OF THE MEMBERSHIP CONTRACT
minors, the card subscription request must be signed by the legal representative.
The holder does not have to prove their main residence in the Grand Est region. The solidarity card has a validity period indicated on the back of the card. However, the holder must be in
possession of his card during his trip, it can only be used upon receipt by the holder.

III - TERMS OF SUBSCRIPTION TO THE SOLIDAIRE CARD At the end of its validity, the card must be destroyed by the holder to prevent any fraudulent use by a third
party.
Card request
On the card's expiry date, a renewal request can be made under the terms of Article III.
Modality of request

To apply for a solidarity card, this solidarity card application form must be completed in a legible manner. It is
available at the counters of a station in the Grand Est region or on the TER Grand Est website:
grandest.ter.sncf.com. IX - TERMINATION OF THE CONTRACT AT THE INITIATIVE OF SNCF
Documents required
The solidarity card may be terminated automatically by SNCF, without any compensation, for the following
The issuance of the solidarity card is subject to eligibility according to the criteria in force and to the provision reasons:
of information and supporting documents sent to the solidarity card processing center, namely: - the duly - in the event of fraud established in the creation of the solidarity card application file, false declaration,
completed and signed subscription form valid acceptance of these general conditions. For unemancipated
falsification of supporting documents
minors, the subscription must be signed by the legal representative. - photocopy of CMUC certificate - in the event of established fraud in the use of a solidarity card:
Any abusive or fraudulent use of the solidarity card may result in its immediate withdrawal and the
- photocopy of the beneficiaries' identity documents application against the user of proceedings and sanctions provided for by law, without prejudice to the
- a recent identity photograph with the name(s) and first name(s) of the card holder(s) on the back (subject to application of the provisions of article XI governing cases of termination.
acceptance). The photograph must be taken without retouching on a neutral background, thus clearly Examples of abusive or fraudulent use: •
highlighting the outline and details of the portrait, the head must be taken from the front or in a maximum use by a third person, except in the case of a report of loss or theft made to the police or gendarmerie
three-quarter view. Only photographs allowing unambiguous identification are accepted. services;
• use of an expired solidarity card;
Issuance of the card • falsification of a card or solidarity transport ticket.
The issuance of the solidarity card is subject to acceptance of the membership application by the issuer. - in the event of an offense on board trains or buses (contempt, damage, etc.)
If accepted by the issuer of the solidarity card, the card (or cards) will be sent directly to the customer's home The card will be collected at the time of control on trains or coaches, or afterwards. The card holder will no
within 15 days by post. longer be able to benefit from the solidarity rate for a period of one year, from the date of the fraud noted.
Acceptance will be positive if all the requested documents are provided and valid. The solidarity card processing center notifies the holder of the termination by letter to inform them of their
In the event of refusal by the issuer, the reasons for the refusal will be indicated by mail or email to the customer. exclusion from the system.
Any holder whose solidarity card has been terminated for established fraud undertakes, if his card has not
Card renewal been withdrawn by a control agent, to return his card within 3 working days following the date of receipt of
The renewal of the solidarity card can only be done at the earliest one month before the expiry date written the letter, by mail to the solidarity card processing center. Any person continuing to use a canceled solidarity
on the card. To do this, you must complete this form and once again attach all the requested documents. card is considered to be without a transport ticket and will have their situation regularized according to the
terms in force.
In addition, generally speaking, SNCF Mobilités has the right to end the use of the solidarity card by ceasing
to offer customers any new membership or renewal of membership. This general termination must be subject
to three (3) months' notice.
IV - DUPLICATE OF THE SOLIDARITY CARD

The loss or theft of a card must be reported as soon as it occurs.

In the event of loss or theft of a solidarity card, the holder will have to submit a new solidarity card application. X - MANAGEMENT OF SOLIDARITY CARDS

No duplicates will be issued. The solidarity card is the property of SNCF Mobilités.
The card holder is responsible for its use and retention.

V - SCOPE AND CONDITIONS OF USE

XI - APPLICABLE LAW AND SETTLEMENT OF DISPUTES
The solidarity card is not equivalent to a transport ticket. It must be accompanied by a valid transport ticket.
The solidarity card can only be used for a journey having as origin and final destination a station located These T&Cs are subject to French law.
within the perimeter of the TER Grand Est network. To travel, the solidarity card holder must bring their card In the event of disputes relating to the interpretation, validity or execution of these T&Cs, the user and SNCF
and a transport ticket valid for the period and route concerned. Mobilités agree to use their best efforts to resolve the dispute amicably.
To be valid, transport tickets must be stamped before accessing the train.
If the card is forgotten or the transport tickets are not collected, the holder will see his situation regularized In the event that an amicable agreement is not reached, any possible dispute relating to the interpretation or
according to the conditions in force. execution of these T&Cs will be submitted to the competent jurisdiction.
The holder is responsible towards SNCF Mobilités and/or third parties for the use of the card and for any
material and/or immaterial, direct and/or indirect damage of any nature whatsoever caused by him and/or his
employees in the event of improper use.
If there is any doubt about the identity of the solidarity card holder, proof of identity may be requested. If the
solidarity card does not correspond to the identity of the holder, it will be withdrawn immediately, according to
the terms of article XI.
The card remains the property of the issuer (SNCF Mobilités). The issuer reserves the right to withdraw or
change the card, for any reason.