(PLEASE USE BLOCK CAPITALS)

Person to be visitedName: ..........................................................................................................................................Address : ................................................................................................................................................................................................................................................................................................Post Code : ............................................ Telephone No. : ..............................................................Relationship to Visitor: ..................................................................................................................

VisitorName: ..........................................................................................................................................Address : ................................................................................................................................................................................................................................ Post Code : ............................................

Vehicle Registration No’s(Maximum of 2 vehicles)

Note: Please read carefullyOnly ONE Family Permit will be issued to any one household. A Permit WILL NOT be issued should any member of the applicant’s household hold a Resident’s Parking Permit.

The permit will be issued for a 12 month period only, and the old permit MUST be surrenderedbefore a new one will be issued.

Permits can only be issued or renewed Monday - Thursday 8:30am - 5:00pm, Friday 8:30am - 4:30pmEither by post or at the Parking Shop, 30D Aberafan Shopping Centre, Port Talbot SA13 1PB.

Self-addressed stamped envelope must be included with all postal applications or applicationwill not be processed.

I sign this application form knowing that I shall be liable to prosecution if I havewilfully stated in it anything, which I know to be false or do not believe to be true.

Signed : ..................................................... (Signature of Applicant) Date : ...........................................Doctor:I confirm that ................................................................................... requires constant visits from........................................................................................................ due to age and/or infirmity.Signed: .........................................................................................................................................

Application for Family Parking Permit

Permit No.

Issue Date:

Expiry Date:

Old Permit:

Send to: The Parking Shop, 30D Aberafan Shopping Centre, Port Talbot SA13 1PB.Tel: 01639 892937 Fax: 01639 892981

Office Use

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(DEFNYDDIWCH LYTHRENNAU BRAS)

Person yr ydych ymweld ag ef/hiEnw: .............................................................................................................................................Cyferiad: ................................................................................................................................................................................................................................................................................................C ^od Post: ............................................ Ff^on. : ............................................................................Perthynas ^a’r ymwelydd: ..................................................................................................................

YmwelyddEnw: .............................................................................................................................................Cyfeiriad: ................................................................................................................................................................................................................................ C ^od Post: : ............................................

Rhif y Car(Uchafswm 2 gar)

Sylwer: Darllenwch yn ofalus

Dim ond UN Trwydded Deulu a fydd yn cael ei dyfarnu i aelwyd. NI FYDD Trwydded yn cael ei dyfarnu os bydd aeold o aelwyd yr ymgeisydd yn meddu ar Drwydded Barcio i Breswylwyr.

Bydd y drwydded yn cael ei dyfarnu am gyfnod o 12 mis yn unig, a RHAID ildio’r hen drwyddedcyn y bydd un newydd yn cael ei dyfarnu.

Gellir cyhoeddi neu adnewyddu trwyddedau ar Ddydd Llun - Dydd Iau 8:30am - 5:00pmDydd Gwener 8:30am - 4:30pmNaill ai drwy’r post neu drwy fynychu’r Siop Barcio, 30D Canolfan Siopa Aberafan,Port Talbot SA13 1PB.

Rhaid cynnwys amlen gyfeiriedig ^a stamp arni gyda phob cais drwy’r post neu ni fydd y cais yn cael ei brosesu.

Rwy’n arwyddo’r ffurflen gais hon gan wybod y byddaf yn atebol i erlyniad os wyfwedi nodi unrhyw beth sy’n anghywir neu’n anwir.

Llofnod: ..................................................... (Llofnod yr Ymgeisydd) Dyddiad : ........................................Meddyg:Rwy’n cadarnhau bod ..................................................................... angen ymweliadau cyson gan....................................................................................................... oherwydd oedran a/neu lesgedd.Llofnod: .........................................................................................................................................

Cais am Drwydded Barcio i’r Teulu

Rhif y Drwydded

Dyddiad Cyhoeddi:

Dyddiad Gorffen:

Hen Drwydded:

Defnydd Swyddogol

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Anfoner At: Yn Y Siop Barcio, 30D Canolfan Siopa Aberafan, Port Talbot SA13 1PB.Ffôn: 01639 892937 Ffacs: 01639 892981