Get E Zpass Ma Application Form

Get E Zpass Ma Application Form

The E-ZPass MA Application Form is a crucial document for individuals looking to establish an E-ZPass account in Massachusetts. This form allows you to register for electronic toll collection, making your travel more efficient and convenient. If you are ready to streamline your toll payments, click the button below to fill out the application form.

Structure

The E-ZPass MA Application form is an essential document for individuals seeking to open an E-ZPass account in Massachusetts. This application is specifically designed for privately owned or leased vehicles with two axles and four tires. It is important to note that operators of vehicles with more than four tires, as well as those with commercial license plates, must follow a different process. The form requires applicants to provide clear personal information, including names, addresses, and contact details, ensuring accurate account setup. Additionally, applicants must list all vehicles that will use the E-ZPass transponders, which are crucial for electronic toll collection. The application also includes options for payment methods, allowing users to choose between direct debit from a checking account, credit/debit card payments, or manual replenishment. Moreover, it emphasizes the necessity of maintaining a sufficient balance in the account to avoid violations. By signing the application, individuals agree to the terms and conditions set forth by the Massachusetts Department of Transportation (MassDOT), which govern the use of the E-ZPass system. Understanding these key components can help applicants navigate the process smoothly and enjoy the benefits of electronic tolling.

E Zpass Ma Application Preview

®

www.mass.gov/ezpassma

1-877-627-7745

APPLICATION FOR INDIVIDUAL E-ZPASS MASSACHUSETTS ACCOUNT

Please note, this Application is for privately owned or leased 2-axle,

Mail or Fax application to:

E-ZPass MA Customer Service Center

4-tire vehicles only. Operators of vehicles with more than 4 tires, or

27 Midstate Drive

vehicles with livery, taxi, combination (plates) or other commercial license

Auburn, Massachusetts 01501-1839

plates should call toll-free 1-877-627-7745, Option 3, then Option 7, to

FAX: 1-508-786-5222

receive a Commercial Business Account Application.

To join online visit www.mass.gov/ezpassma

PLEASE PRINT CLEARLY

Personal

Information

Statement

Options

(check only one)

Vehicle

Information

IMPORTANT

As it appears on your vehicle registration

REQUIRED - 4 DIGIT PERSONAL PIN NUMBER

 

 

 

 

 

 

 

 

 

IMPORTANT

 

 

AUTHORIZED ALTERNATIVE CONTACT

 

 

 

 

 

 

 

 

 

 

(Select any 4 numbers to access your account information

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

online or over the phone)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST NAME

 

 

 

 

 

FIRST NAME

 

 

 

 

MI

 

 

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

 

 

 

 

CITY

 

 

 

 

 

 

STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

 

WORK PHONE

 

 

 

CELL PHONE

 

 

 

 

 

 

FAX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please do not send a monthly account

 

 

Please e-mail a link to my monthly account

Please mail a monthly account statement to the address listed above.

statement; I can use the on-line Account

 

 

statement each month. I have provided my

I understand that there is a $2.00 monthly fee for this service and

Manager to access my statement.

 

 

e-mail address above.

 

 

 

 

 

I authorize E-ZPass MA to deduct this fee from my E-ZPass MA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

account each month.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

List all vehicles that will be using your E-ZPass MA transponders.

 

 

 

 

 

 

Reminder Please remember to always update your account with any

Please note that you must list at least one vehicle for each transponder requested.

 

 

 

 

changes or additions to vehicle(s) or personal information.

LICENSE PLATE NO.

PLATE TYPE

 

STATE

 

 

 

 

 

MAKE & MODEL OF VEHICLE

 

 

 

 

 

YEAR

INDICATE IF LEASED VEHICLE

(Reference Vehicle Registration)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Transponder(s)

Please indicate the number of transponders you are requesting.

 

 

(Maximum 4 transponder(s) per account)

TRANSPONDERS REQUESTED

Toll Payment Options (check only one)

OPTION B Direct Payment from Checking Account

By Choosing Option B: You hereby authorize E-ZPass MA to initiate debit entries from your checking account to automatically replenish your E-ZPass MA account whenever the account balance falls below the Low Balance threshold. This authorization is to remain in full force and effect until E-ZPass MA has received written notification of its termination in such time and in such manner as to afford E-ZPass MA reasonable opportunity to act on it.

OPTION B

$ 20

OPENING ACCOUNT BALANCE

Checking Account Routing NumberChecking Account Number (If easier attach a voided check from your checking account)

OPTION C Direct Payment from Credit/Debit Card

By Choosing Option C: You hereby authorize E-ZPass MA to initiate debit entries from your credit/debit card listed below to automatically replenish your account whenever the account balance falls below the Low Balance threshold. This authorization is to remain in full force and effect until E-ZPass MA has received written notification of its termination in such time and in such manner as to afford E-ZPass MA reason- able opportunity to act on it.

 

PLEASE CHECK ONE:

MC

VISA

DISC

AMEX

 

 

 

Credit/Debit Card Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EXPIRATION (Month/Year)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OPTION D Manual Account Replenishment (If mailing application, please include initial payment)

 

 

Customers Choosing Option D are required to maintain a sufficient pre-paid balance in their account. At some locations, you will see a yellow

 

 

“Low Balance” light in the designated lane when your E-ZPass MA account balance falls below the low balance threshold; this yellow “Low

 

 

Balance” light indicates that you will need to replenish your account by mailing a check or making a payment at one of the E-ZPass MA Customer

 

 

Service Centers. If your account falls below $0.00 you will be issued a toll violation. A Pay-By-Plate MA invoice will be issued for travel on

 

 

the Tobin Bridge. Cash Payments: Cash preferred customers can replenish their E-ZPass MA accounts using self-service kiosks with cashier

 

 

assistance at retail cash payment locations. A convenience fee for each E-ZPass payment will be charged.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Authorization

I have read the information on this application, including the terms and conditions. I authorize payment as

 

 

selected, and certify that all information contained in the application is true and accurate.

 

IMPORTANT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CUSTOMER SIGNATURE REQUIRED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOW E-ZPASS WORKS

E-ZPass provides customers with electronic toll collection through the use of a transponder. As you pass through a designated E-ZPass lane, the transponder is read, a green “Thank You” light is flashed, and your toll transactions are recorded in your E-ZPass account.

OPTION C

$ 20

OPENING ACCOUNT BALANCE

OPTION D

$ 20

OPENING ACCOUNT BALANCE

 

Clerk ID

❏ Gift Certificate

 

❏ Cash

$:

Acct#:

 

 

 

E-ZPass MA use

 

 

 

 

 

 

 

ACH-Prepaid

❏ Credit Card

❏ Check

 

 

Date

 

Tag#

 

 

 

 

 

 

 

 

only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03/2015

The Massachusetts Department of Transportation (“MassDOT”) establishes these terms and conditions that govern the use of the Electronic Toll Collection (“ETC”) E-ZPass system and require that account holders/customers accept these terms and conditions.

Use of the E-ZPass system is limited to customers who join the E-ZPass program and maintain their account in good standing. An E-ZPass customer in “good standing” means a customer who: (1) submitted a completed E-ZPass application to MassDOT’s E-ZPass MA Customer Service Center; (2) affixed the transponder(s) in accordance with the instructions provided; (3) maintains their account current, with sufficient balance at all times to pay for all E-ZPass transactions; and (4) uses the E-ZPass system in accordance with the E-ZPass Program Agreement and MassDOT’s regulations.

The following terms and conditions supersede any terms and conditions you may have previously received. These terms and conditions, together with your application, constitute the E-ZPass Program Agreement. Please read all of the terms and conditions and the entire application prior to using an E-ZPass transponder. When a transponder assigned to you is used, you agree as follows:

1. TERMS

a)MassDOT may, at any time, suspend or terminate your E-ZPass account, and/or electronically deactivate your E-ZPass transponder(s) for violation of applicable laws, regulations, or the terms and conditions of the E-ZPass Program Agreement. You shall remain and be liable for payment of all fines, penalties, costs, fees, and any other monies owed pursuant to the terms of this agreement and any applicable law.

b)MassDOT reserves the right to reject any E-ZPass application.

c)If any of the terms of this agreement are declared or found to be illegal, unenforceable or void, then MassDOT and

the E-ZPass customer shall be relieved of all obligations under that term. The remainder of the agreement shall be enforced to the fullest extent permitted by law.

2. TRANSPONDER USAGE

a)You agree that the E-ZPass transponder(s) remains the property of MassDOT. This is required for manufacturer warranty purposes, and to establish a mechanism for the proper disposal of an inoperable transponder once you return it to MassDOT.

b)You agree to affix the E-ZPass transponder(s) in the vehicle(s) in accordance with the instructions provided and to use the transponder(s) only in the vehicles that you have listed on your application, and updated as neces- sary. Failure to do so may subject you to a Violation Fine, a Video-Toll (“V-Toll”) Administrative Fee, or an invoice from the Pay By Plate (“PBP”) All Electronic Toll (AET) system at the PBP toll rate that is established by MassDOT.

c)You agree that you may not use any designated E-ZPass lane unless the vehicle is properly equipped with an E-ZPass transponder and that vehicle has been listed on or added to your account.

d)You acknowledge that you are required to enter and exit all toll plazas through a designated E-ZPass lane. Oth- erwise, you will be required to pay your toll in cash at a designated cash toll booth, except if the vehicle is a Two Axle Commercial Vehicle. Two Axle Commercial vehicles are required to have a transponder and use a designated E-ZPass lane in accordance with 700 CMR 7.03(9) and these Terms and Conditions.

e)When traveling on the Massachusetts Turnpike’s ticket system (interchanges west of Route 128/I-95) and a point of exit, but no point of entry, is registered for the E-ZPass transaction, or upon the posting of a V-Toll at point of exit, you agree that the E-ZPass system will use the entry point that is farthest from the point of exit when calculating the toll amount. You may only contest the toll amount in writing to the Customer Service Center in accordance with Section 6 below. If the toll is reduced, your E-ZPass account will be credited the amount of the reduced toll.

f)You agree that you will comply with the posted speed limit. You are advised and you agree that exceeding the posted speed limit will subject you to fines and penalties and/or termination of your E-ZPass account.

g)You agree to obey all applicable federal and state laws and regulations governing the use and operation of Mass- DOT’s facilities and the E-ZPass Program. Failure to do so may result in fines and penalties and/or termination of your E-ZPass account.

h)You agree to pay all costs associated with the use of the E-ZPass transponder(s) assigned to you.

i)You agree to obey all signage, postings and signal messages in the E-ZPass lanes. You agree that you will not use the E-ZPass lane after you have received a message in the lane to “CALL E-ZPass” (signifying that a violation has occurred) until you have contacted the Customer Service Center and verified that your E-ZPass account is in good standing. Failure to do so may result in additional costs, fines and penalties. This message will not be displayed on a roadway that has AET.

j)MassDOT may enter into reciprocal agreements with other agencies. If your E-ZPass transponder(s) is used at any toll facility, parking facility or other facility accepting E-ZPass as a payment mechanism you agree that all charges incurred in connection with the use of your E-ZPass transponder(s) will be charged to your account and that you are responsible for all such charges.

k)In accordance with 700 CMR 7.03(9), Two Axle Commercial Vehicles, as defined in MassDOT’s regulations, op- erating on certain ways where MassDOT assesses a toll are required to use E-ZPass to pay tolls and must enter and exit all toll plazas through a designated E-ZPass lane, where applicable. Two Axle Commercial Vehicles are not allowed to pass through a manual lane and are not allowed to pay cash at a cash toll booth on certain non- AET ways, unless there is no designated E-ZPass lane in operation at the time the vehicle passes through the toll interchange. You acknowledge and agree that any use of the manual lanes or PBP system to attempt to pay cash for a toll on certain ways is in violation of this provision by such Two Axle Commercial Vehicles and is prohibited. The registered owner of any such Commercial Vehicle may be subject to fines and penalties under MassDOT’s regulations, other applicable laws, and/or for breach of these Terms & Conditions. You agree that if you are in violation of this provision, you shall pay any such assessed fines and penalties.

l)A roadway or facility that has All Electronic Tolling (“AET”) does not have designated E-ZPass lanes and any lane

may be used by an E-ZPass account holder.

3. LOST/STOLEN AND DEFECTIVE TRANSPONDERS

a)You agree that you will notify the Customer Service Center immediately if your transponder(s) is lost or stolen. You agree that you are responsible for any costs associated with any and all uses of the E-ZPass transponder(s) assigned to your account prior to such notification. The replacement fee for lost or stolen transponder(s) is equal to the amount of the Transponder Fee and Transponder Administrative Fee applicable as of the replacement date.

b)Defective E-ZPass transponders must be brought or sent to a Customer Service Center for testing and evaluation.

At the discretion of MassDOT, defective E-ZPass transponders may be replaced free of charge. If the E-ZPass transponder shows signs of misuse or abuse you will be required to pay a fee per 3(a) above.

4. YOUR E-ZPASS ACCOUNT

a)You authorize MassDOT to access and charge all costs associated with the use of your E-ZPass transponder(s) to the credit/debit card listed on your application or your bank account, as applicable.

b)You authorize MassDOT to access and charge all fees associated with your participation in the E-ZPass Program and associated use of a transponder to your E-ZPass account and to the credit/debit card, bank account, or other chosen method of replenishment for your account. The Fee(s) authorized hereunder include, but are not limited to, transactional, administrative, periodic administrative (i.e. monthly, yearly, etc.), and any other type of fee(s), as may be set and assessed at MassDOT’s discretion from time to time without prior written notice. Information relating to such fees and a current Fee Schedule may be obtained by contacting the Customer Service Center or online at www.mass.gov/ezpassma. If you close your E-ZPass account, such fees will not be refunded, except as otherwise determined by MassDOT from time to time on the Fee Schedule.

c)You acknowledge that MassDOT may review periodically the activity in your account and adjust your replenish- ment amount, if applicable, to more accurately reflect the average monthly charges and fees incurred by you.

d)You shall not assign the obligations or benefits of this agreement without the express written consent of MassDOT or the Customer Service Center.

e)If you have selected “Automatic Account Replenishment” as the payment method for your E-ZPass charges, you agree that you are responsible for providing the Customer Service Center with a credit/debit card in good stand- ing (i.e., valid, not expired and below the maximum balance), a banking account with sufficient funds, or a positive balance in your manual replenishment account, at all times to cover the costs and fees associated with your use of the ETC transponder(s).

f)If you have selected “Manual, Credit/Debit, or Bank Account Replenishment” as the payment method for your E-ZPass charges and your balance falls to or below $0.00 you will be subject to the issuance of a Violation Fine and account termination. In lieu of account termination you may be allowed to retain your E-ZPass account,

provided any outstanding balance is paid in full and you enroll in an automatic account replenishment payment method which includes use of a valid credit/debit card or bank account.

g)You acknowledge and agree that MassDOT shall not pay any interest on any E-ZPass account pre-paid balance or any transponder deposit.

h)You acknowledge and agree that you will be charged a fee for each returned check for your E-ZPass Program account.

i)You certify that all information contained in your E-ZPass application is true and accurate. You agree to notify im- mediately the Customer Service Center if any of the information contained in your application changes, including but not limited to, changes to address, credit/debit card, bank account information, and vehicle and license plate information. Failure to do so may subject you to additional fines and fees.

j)Administrative fees may be billed directly to your account. You may contest the imposition of said administra- tive fees in writing to the Customer Service Center within sixty (60) days of the disputed charge. If the fee is rescinded, your E-ZPass account will be credited the amount of the rescinded fee.

k)Unpaid balances due to MassDOT may be turned over to a collection agency for enforcement and collection activities along with any other legal action that MassDOT is authorized to pursue to recover such monies owed.

5.VIOLATIONS AND “VIDEO TOLL” (V-TOLL) FEES

a)In cases where your E-ZPass transponder is not read, but an image of the vehicle’s license plate is captured in the lane and the license plate information for the vehicle is listed in your account, the appropriate toll amount shall be deducted from your account by use of the video image, referred to herein as a “video toll” or “v-toll.” A Video Toll (“V-Toll”) Administrative Fee shall also be applied to your account.

b)You acknowledge and accept that you are required to maintain your E-ZPass account in good standing at all times and that if your account balance falls to or below $0.00 you will be subject to a fine and penalties for unauthorized use of the ETC lane under 700 CMR 11.00 et. seq and 700 C.M.R. 7.04 et. seq.

c)You agree that in the event your account falls to or below $0.00 due to an expired or rejected credit card, an insuf- ficient bank account balance or an insufficient pre-paid balance and you proceed through an E-ZPass lane, you are in violation of the E-ZPass Program Agreement and MassDOT regulations, and you are subject to a violation and penalties under700 C.M.R. 11.00 et. seq. and 700 C.M.R. 7.04 et. seq.

d)Any use of an E-ZPass lane by a vehicle that is not listed on an E-ZPass account; an E-ZPass account not in good standing; or an invalid member of E-ZPass is prohibited, and the registered owner of any such vehicle is subject to a fine and penalties under MassDOT regulations. Any E-ZPass account holder who is not in good standing and travels on an AET roadway will be subject to the PBP process and will receive an invoice and the toll shall be at the PBP toll rate.

e)If you rent or lease a vehicle and receive an E-ZPass violation you are advised that under Massachusetts Law, MassDOT must issue a violation to the registered owner of the vehicle (the rental or leasing company). You agree that, upon receipt of the name and address of the renter/lessee along with sufficient proof or such rental or lease, MassDOT may issue the violation to the renter/lessee. You agree that you, as the renter/lessee will be liable for any violation issued to the license plate associated with your rented or leased vehicle during the term of your rental or lease agreement. MassDOT has no obligation or liability whatsoever in any rental or leasing agreement.

f)You are advised and acknowledge that violation enforcement cameras are used in the E-ZPass and AET lanes. You agree that if you are issued a violation for unauthorized use of the ETC System you are required to adhere to MassDOT’s regulations 700 CMR 11.00 et. seq. and 700 C.M.R. 7.00-7.12 et. seq. for the payment or appeal of any viola- tions. Under MassDOT’s regulations you must pay or appeal in writing any violation issued to you within sixty (60) days. You are advised and acknowledge that cameras are also used in the AET lanes for the purpose of PBP invoicing.

g)Failure to pay or appeal violation fines within the time period and in the manner described on the violation notice may result in additional Violation Administrative/Late Fees, the termination of your account, the non-renewal of your driver’s license and vehicle registration by the Registry of Motor Vehicles (RMV), and an RMV Non-Renewal “Mark- ing Fee,” along with any other legal action that MassDOT is authorized to pursue to recover such monies owed.

h)You agree that the information provided to, or contained in your E-ZPass Account can be used by MassDOT in any

administrative or legal proceeding by MassDOT to collect any monies owed by you to MassDOT.

6. DISPUTES/REFUNDS

In accordance with Section 169 of Chapter 25 of the Acts of 2009, the time permissible for an account holder to dis- pute an overcharge of the electronic toll system is three (3) years from the time of the overcharge. If you dispute any overcharge to your ETC account you agree to notify the Customer Service Center in writing at 27 Midstate Drive, Auburn, MA 01501, within such period. MassDOT will investigate the dispute and will make a good faith determination of whether an adjustment is warranted. You agree that the good faith determination of MassDOT with regard to your dispute shall be final and binding upon you.

7. DISCLAIMER

a)MassDOT shall have no responsibility or liability to you for any loss, cost, expense or damage to you, any pas- sengers or your vehicle, arising out of your failure to comply with any laws or regulations, or any terms and condi- tions of the E-ZPass Program Agreement, or out of your misuse or abuse of an E-ZPass transponder, or failure to follow instructions for the use and operation of E-ZPass transponder(s).

b)Under no circumstances shall MassDOT have any liability for any consequential, indirect, special, incidental, or punitive damages of any kind arising out of your participation in the E-ZPass or PBP Program.

c)Except for its obligations under paragraph 3 (b) above, MassDOT makes no representations or warranties, ex- press or implied, with respect to the merchant ability or fitness for a particular purpose or any other reason with respect to E-ZPass transponders and/or the E-ZPass Program.

d)Except as otherwise specified herein, MassDOT shall have no liability or obligation of any kind what so ever arising out of a) your use of or the performance of the E-ZPass transponder, b) any defect or malfunction of an E-ZPass transponder or any defect or malfunction in any E-ZPass lane, or c) the failure of any E-ZPass lanes to operate at any time or the unavailability of any E-ZPass lanes at any toll plaza.

e)MassDOT does not warrant that there will be any E-ZPass lanes, or that any particular number of E-ZPass lanes will be available at any toll plaza, or that E-ZPass will be available at any other facilities.

f)You agree to indemnify, defend, and hold harmless MassDOT from and against any and all damage, loss, cost,

expense, or liability relating to, arising from, or as a result of the use or performance of the E-ZPass transponder.

8. COLLECTION EXPENSES

You agree to pay MassDOT’s costs, including attorneys’ fees, required to enforce the terms and conditions of the E-ZPass Program and the collection of monies in connection with the use of your E-ZPass transponder(s).

9. NON-DISCLOSURE

In accordance with the provisions of G.L. c. 6C, Section 13 (a), MassDOT and the Customer Service Center shall hold all customer account information confidential, except as otherwise authorized for MassDOT administrative and legal proceedings.

10. GOVERNING LAWS

The E-ZPass Program Agreement shall be governed by the laws of the Commonwealth of Massachusetts. Any legal proceeding arising out of or under the E-ZPass Program Agreement shall be brought in Superior Court, Suffolk County in Boston, Massachusetts.

11. TERMINATION

You may terminate this agreement at any time by returning your transponder(s) to the Customer Service Center. Transponders should be returned in person or by first class prepaid mail. Transponders will remain the property of MassDOT under all circumstances. Upon termination of this agreement and return of your transponder(s), your account balance will be refunded to you. All outstanding charges will be deducted prior to refund.

12. MODIFICATIONS

MassDOT may change the “E-ZPass Program Terms and Conditions” at any time by giving customers notice thereof. The terms and conditions shall become effective seven (7) days after such notice has been given. No written notice is required, and you hereby waive any requirement that written notice be provided. Such notice may be given through any means, including, but not limited to, advertising such notice in the media, posting such notice on message boards along MassDOT’s toll roadways, posting such notice on the MassDOT website, or otherwise, as determined by MassDOT. If you have provided an electronic mailing address to MassDOT with your application, you authorize that such notice may be provided by sending such notice to that electronic mail address, in MassDOT’s discretion.

Effective as of December 2014

Document Data

Fact Name Description
Application Purpose This application is designed for individuals seeking to open an E-ZPass account for privately owned or leased 2-axle and 4-tire vehicles in Massachusetts.
Contact Information For assistance, applicants can call 1-877-627-7745 or visit the website at www.mass.gov/ezpassma.
Transponder Limit Each account can request a maximum of four transponders. It's essential to list at least one vehicle for each transponder requested.
Monthly Fee There is a $2.00 monthly fee for account statements sent via email, which will be automatically deducted from the account balance.
Governing Laws The E-ZPass Program Agreement is governed by the laws of the Commonwealth of Massachusetts, specifically under regulations 700 CMR 11.00 et. seq. and 700 CMR 7.00-7.12 et. seq.

How to Use E Zpass Ma Application

Completing the E-ZPass MA application form is straightforward. Follow the steps outlined below to ensure you provide all necessary information accurately. Once your application is submitted, you will receive confirmation and further instructions regarding your E-ZPass account.

  1. Visit the E-ZPass MA website or obtain a physical application form.
  2. Print the application form clearly.
  3. Fill out the Personal Information section, including your last name, first name, middle initial, email, street address, city, state, zip code, and phone numbers.
  4. Select one option for your Statement Options: choose between receiving a monthly account statement by email or mail.
  5. List all vehicles that will use your E-ZPass transponders in the Vehicle Information section. Provide the license plate number, plate type, state, make and model, year, and indicate if it's a leased vehicle.
  6. Indicate the number of transponders you are requesting (maximum of 4) in the Transponder(s) section.
  7. Choose a Toll Payment Option: select either Direct Payment from Checking Account, Credit/Debit Card, or Manual Account Replenishment.
  8. If you choose Direct Payment, provide your checking account routing and account number or credit/debit card details, including the card number and expiration date.
  9. Read the authorization statement and sign the application. Include the date of signing.
  10. Mail or fax the completed application to the E-ZPass MA Customer Service Center at the address provided on the form.

Key Facts about E Zpass Ma Application

What is the E-ZPass MA application form used for?

The E-ZPass MA application form is designed for individuals who wish to open a personal E-ZPass account in Massachusetts. This account allows users to electronically pay tolls while traveling on designated toll roads. The application is specifically for privately owned or leased 2-axle and 4-tire vehicles. If you operate a vehicle with more than 4 tires or a commercial vehicle, you will need to contact E-ZPass MA directly for a different application.

How can I submit the E-ZPass MA application?

You can submit your E-ZPass MA application in several ways. You can mail or fax the completed form to the E-ZPass MA Customer Service Center at 27 Midstate Drive, Auburn, Massachusetts 01501-1839. The fax number for submissions is 1-508-786-5222. Alternatively, you can also apply online by visiting the official E-ZPass MA website at www.mass.gov/ezpassma.

What information do I need to provide on the application?

The application requires personal information such as your name, address, and contact details. You must also provide information about the vehicle(s) that will be using the E-ZPass transponder, including the license plate number, make and model, and whether the vehicle is leased. Additionally, you will need to choose a payment option and provide a personal PIN number for account access.

Are there any fees associated with the E-ZPass MA account?

Yes, there are fees associated with maintaining an E-ZPass MA account. There is a $2.00 monthly fee for receiving electronic statements via email. Additionally, if you choose to use a checking account or credit/debit card for automatic replenishment, you may incur fees based on your account activity. It's important to keep your account in good standing to avoid any additional charges or penalties.

What should I do if my E-ZPass transponder is lost or stolen?

If your E-ZPass transponder is lost or stolen, you must notify the E-ZPass MA Customer Service Center immediately. You will be responsible for any charges incurred using the transponder before you report it lost or stolen. A replacement fee may apply for the lost or stolen transponder, and you will need to follow the proper procedures to obtain a new one.

Common mistakes

Filling out the E-ZPass MA Application form can be straightforward, but there are common mistakes that applicants often make. One significant error is failing to provide accurate personal information. This includes the name, address, and contact details. If any of this information is incorrect, it can lead to delays in processing the application or issues with account management later on.

Another common mistake is neglecting to list at least one vehicle for each transponder requested. The application requires that applicants specify the vehicles that will be using the E-ZPass transponders. Omitting this information can result in the application being rejected or delayed.

Additionally, many applicants overlook the importance of selecting the correct payment option. The application offers several choices for account replenishment, such as direct payment from a checking account or credit/debit card. Choosing the wrong option can complicate the funding process for the E-ZPass account.

Some people also forget to sign the application. A missing signature can cause the application to be deemed incomplete. This simple oversight can lead to unnecessary delays in obtaining an E-ZPass account.

Moreover, applicants sometimes fail to read and understand the terms and conditions associated with the E-ZPass program. Ignoring these details can lead to misunderstandings about fees, penalties, and account management responsibilities.

Lastly, many individuals do not provide an email address or provide an incorrect one. This is crucial for receiving account updates and statements. Without a valid email address, applicants may miss important communications regarding their account.

Documents used along the form

The E-ZPass MA Application form is a crucial document for individuals looking to set up an E-ZPass account in Massachusetts. However, several other forms and documents often accompany this application to ensure a smooth enrollment process. Below is a list of these additional documents, each serving a specific purpose in conjunction with the application.

  • Vehicle Registration Document: This document verifies the ownership of the vehicle(s) that will be using the E-ZPass transponder. It includes essential details such as the vehicle's make, model, year, and license plate number, ensuring that the information provided on the application matches the registered vehicle.
  • Proof of Identity: A government-issued ID, such as a driver's license or passport, is often required to confirm the identity of the applicant. This helps prevent fraud and ensures that the account is set up under the correct individual.
  • Payment Authorization Form: This form outlines the method by which the applicant intends to fund their E-ZPass account, whether through direct debit from a bank account or credit card. It authorizes E-ZPass to withdraw funds as needed to maintain a sufficient balance.
  • Account Replenishment Agreement: This document details the terms for replenishing the E-ZPass account, including thresholds for automatic replenishment. It ensures that users understand how and when their accounts will be funded to avoid service interruptions.
  • Customer Service Contact Information: This includes the contact details for the E-ZPass Customer Service Center. Having this information readily available allows users to easily reach out for assistance or clarification regarding their accounts.

In summary, while the E-ZPass MA Application form is essential for establishing an account, these accompanying documents play vital roles in ensuring that the application process is efficient and secure. Understanding each document's purpose can help applicants prepare adequately and avoid potential delays in obtaining their E-ZPass account.

Similar forms

The E-ZPass MA Application form shares similarities with several other documents commonly used in various transactions and registrations. Below is a list detailing six such documents and their similarities to the E-ZPass application:

  • Vehicle Registration Form: Like the E-ZPass application, this form collects personal and vehicle information, including the owner's name, address, and vehicle details. Both require accurate information to ensure proper identification and registration.
  • Bank Account Application: This document often requires personal information, including account numbers and authorization for transactions. Similarly, the E-ZPass application requests banking details for automatic replenishment of funds.
  • Insurance Application: Just as the E-ZPass application gathers personal details and vehicle specifics, an insurance application requires similar information to assess risk and coverage. Both forms aim to establish a relationship based on accurate data.
  • Credit Card Application: This document seeks personal identification and financial information to evaluate creditworthiness. The E-ZPass application mirrors this by requiring financial data for account funding and maintenance.
  • Utility Service Application: Similar to the E-ZPass form, a utility application collects personal details and payment preferences. Both documents facilitate the initiation of a service based on the applicant's provided information.
  • Membership Application: This type of application often requires personal details and preferences for communication. The E-ZPass application also asks for contact information and preferences regarding account statements, creating a streamlined process for managing services.

Dos and Don'ts

When filling out the E-ZPass MA application form, it’s important to approach the task with care. Here’s a list of things you should and shouldn’t do to ensure a smooth application process.

  • Do print clearly to avoid any misinterpretations of your information.
  • Do double-check that all personal information is accurate and up-to-date.
  • Do list at least one vehicle for each transponder you are requesting.
  • Do read the terms and conditions carefully before signing the application.
  • Don’t forget to provide a valid email address if you wish to receive account statements electronically.
  • Don’t skip any required fields; incomplete applications may be rejected.
  • Don’t use the application for vehicles with more than four tires without contacting customer service.
  • Don’t ignore the instructions for affixing your transponder; proper placement is crucial for functionality.

Misconceptions

  • Misconception 1: The E-ZPass MA application is only for cars.
  • This is incorrect. The application is specifically for privately owned or leased 2-axle vehicles. However, it does not cover vehicles with more than 4 tires or commercial vehicles, which require a different application process.

  • Misconception 2: You cannot apply for E-ZPass online.
  • In fact, individuals can join the E-ZPass program online by visiting the official website, making the application process more convenient.

  • Misconception 3: You must provide a credit card to apply.
  • While providing a credit card is one option for account replenishment, applicants can also choose to set up direct payments from a checking account or opt for manual replenishment.

  • Misconception 4: All vehicles on the account must be registered in Massachusetts.
  • This is not necessarily true. While the application is for Massachusetts residents, it is possible to include vehicles registered in other states, provided they are listed on the application.

  • Misconception 5: There is no fee associated with having an E-ZPass account.
  • There is a $2.00 monthly fee for account maintenance, which will be deducted from the E-ZPass account if the applicant opts for electronic statements.

  • Misconception 6: You can apply for an E-ZPass account without listing any vehicles.
  • This is false. The application requires at least one vehicle to be listed for each transponder requested, ensuring that the account is properly set up for toll usage.

  • Misconception 7: Once you apply, you cannot make changes to your account.
  • Applicants are encouraged to update their account with any changes to vehicle or personal information. This helps maintain accurate records and avoid potential fines.

  • Misconception 8: E-ZPass transponders can be shared between vehicles.
  • This is a misunderstanding. Each transponder is assigned to specific vehicles listed on the account, and sharing them between vehicles not registered on the account may result in fines.

  • Misconception 9: You will not be charged if your account balance falls below zero.
  • This is incorrect. If the account balance falls below zero, the account holder may face fines and penalties, including the issuance of a toll violation.

Key takeaways

Key Takeaways for Filling Out the E-ZPass MA Application Form

  • Ensure all personal information is filled out clearly. This includes your name, address, and contact details. Inaccurate information can delay your application.
  • List at least one vehicle for each transponder requested. Remember to include the license plate number and vehicle details, as this is essential for proper processing.
  • Select your preferred payment method carefully. Options include direct debit from a checking account, credit/debit card, or manual replenishment. Understand the implications of each choice, especially regarding fees.
  • Keep your account updated. Notify E-ZPass MA of any changes to your personal or vehicle information to avoid penalties and ensure smooth operation of your account.