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The E-ZPass Massachusetts Application Form serves as the gateway for individuals seeking to establish an electronic toll collection account. Designed specifically for privately owned or leased two-axle, four-tire vehicles, the form requires applicants to submit essential personal information, including their name, address, and contact numbers. The application also mandates the listing of at least one vehicle that will utilize the E-ZPass transponder, establishing a quick connection between users and their toll transactions. Furthermore, it includes sections for choosing payment options, where applicants can select between direct payment from a checking account, credit/debit card transactions, or manual account replenishment. An important aspect of the form is the 4-digit Personal Identification Number (PIN) that applicants create, which is necessary for accessing account information online or through customer service. Additional choices, like whether to receive monthly statements via email or postal service, are also outlined, enabling customizable service. Users must recall that maintaining accurate account information is crucial, as updates to vehicle details or personal data are required to avoid penalties. By signing the application, individuals acknowledge the terms and conditions laid out by the Massachusetts Department of Transportation, establishing the legal framework for their participation in the E-ZPass program.

E Zpass Ma Application Example

®

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

Get E Zpass Ma Application PDF Form

Form Characteristics

Fact Name Description
Application Purpose This application is used to open an individual E-ZPass account for privately owned or leased 2-axle, 4-tire vehicles in Massachusetts.
Contact Information For assistance, you can call 1-877-627-7745 or visit www.mass.gov/ezpassma.
Transponder Limit Each account can request a maximum of four transponders.
Payment Options Three payment methods are available: automatic debit from a checking account, credit/debit card payments, or manual replenishment.
Monthly Fees A $2.00 monthly fee applies if you select electronic statements. This fee will be deducted directly from your E-ZPass MA account.
Governing Laws The E-ZPass program is governed by the laws of the Commonwealth of Massachusetts, including applicable regulations by MassDOT.

Guidelines on Utilizing E Zpass Ma Application

Completing the E-ZPass Massachusetts application form is an essential step for anyone seeking convenient toll payment options. Make sure to gather your personal and vehicle details before starting. Following these steps will guide you through the process efficiently, ensuring everything is filled out correctly.

  1. Provide your personal information clearly. Fill in your last name, first name, middle initial, email address, street address, city, state, and ZIP code.
  2. Add your contact numbers: home phone, work phone, cell phone, and fax number if applicable.
  3. Choose your statement options. Decide if you prefer an email link, a mailed account statement, or to access your statements online. If you opt for email, ensure to include your email address in the personal information section.
  4. List the vehicles that will use your E-ZPass transponder(s). Include each vehicle's license plate number, plate type, state, make and model, year, and whether the vehicle is leased.
  5. Indicate how many transponders you are requesting (maximum of 4 per account).
  6. Select a toll payment option by checking the appropriate box: Automatic payment from a checking account, credit/debit card, or manual replenishment.
  7. For direct payment options, fill in the necessary bank or credit card details accurately.
  8. Read the terms and conditions carefully, then provide your signature and date to authorize the application.

Once you have completed the form, review it for accuracy. Submit your application by mailing or faxing it to the E-ZPass MA Customer Service Center at the address indicated. Ensuring that everything is complete and accurate will expedite your account setup process.

What You Should Know About This Form

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

The E-ZPass MA application form is used to create an account for individuals who wish to enroll in the E-ZPass program in Massachusetts. This program allows users to pay tolls electronically using a transponder, making travel on toll roads more convenient and efficient.

2. Who can fill out the E-ZPass MA application?

This application is designed for individuals who own or lease privately owned vehicles that have 2 axles and up to 4 tires. If you have a vehicle that fits these criteria, you can complete the application. Commercial vehicle operators or those with more than 4 tires should contact customer service for the appropriate forms.

3. How many transponders can I request on my application?

You can request a maximum of four transponders per account. Make sure to list all vehicles that will be using the transponders on your application to ensure proper setup.

4. What payment options are available for maintaining my E-ZPass account?

The application offers several payment options: Direct Payment from a Checking Account, Direct Payment from a Credit/Debit Card, and Manual Account Replenishment. Choose the one that best suits your needs, keeping in mind that certain fees may apply based on your selection.

5. What is the opening balance I need to maintain in my E-ZPass account?

An opening balance of $20 is required when you set up your E-ZPass account. This balance helps ensure that you have enough funds available for toll payments as you travel.

6. What should I do if my transponder is lost or stolen?

If your transponder is lost or stolen, it’s important to notify the Customer Service Center immediately. You will be responsible for any charges incurred prior to reporting the loss. There may also be a replacement fee for lost or stolen transponders.

7. How can I update my personal information or vehicle details?

It’s crucial to keep your account information current. Anytime you change your vehicle or personal information, you should update your account. This can usually be done online or by contacting customer service directly.

8. Are there any fees I should be aware of?

Yes, there may be administrative fees depending on how you manage your account. For example, there’s a $2 monthly fee for those who choose to receive electronic statements. It's important to review any applicable fees when completing your application.

9. How do I terminate my E-ZPass account?

You can terminate your E-ZPass account at any time by returning your transponder(s) to the Customer Service Center. Make sure to return them in person or through prepaid mail, as transponders remain the property of MassDOT even if you discontinue use.

Common mistakes

Completing the E-ZPass MA Application form can be straightforward, yet several common mistakes can lead to delays or rejected applications. One significant error is failing to provide complete personal information. Individuals often skip critical fields, such as their last name or email address. Each section must be filled out accurately to avoid any processing issues.

Another frequent mistake involves the incorrect entry of vehicle details. Applicants may list vehicles not registered under their name, which can lead to confusion and potential violations. It’s essential to ensure that each vehicle listed corresponds with the submitted vehicle registration documentation to prevent any discrepancies.

People sometimes overlook the requirement for a personal PIN number. This four-digit code is required for accessing account information. If omitted, it creates an extra hurdle in managing the account. Additionally, careless errors, such as typos in the license plate number or vehicle identification number, can result in improper account setup.

Many applicants also underestimate the importance of selecting a payment option. Option B (checking account), Option C (credit/debit card), or Option D (manual replenishment) selections must align with the applicant's financial situation. Selecting an incorrect option can lead to issues with account funding and replenishment, complicating toll payment processes.

Furthermore, individuals often forget to indicate if their vehicle is leased. This information is crucial, as it affects both account management and potential liability for toll violations. Missing this detail could lead to processed applications that do not reflect the vehicle ownership correctly.

There is also a tendency to neglect signature requirements. Failing to sign and date the application can result in an immediate rejection, requiring the applicant to resubmit the entire form. Thus, reviewing the entire application for a signature is vital before submission.

Many applicants assume that they can use the E-ZPass account without regular updates. However, failing to report changes in personal or vehicle information can lead to complications, such as failed transactions or toll violations. Keeping the account updated is an ongoing responsibility for E-ZPass users.

It is also common for applicants to miss providing a valid email address. This email serves as a crucial line of communication regarding account status and updates. An invalid or missing email can result in missed notifications that are essential for maintaining account integrity.

Lastly, misunderstanding the terms and conditions can create issues later on. Applicants should take the time to read these thoroughly. Familiarity with the regulations, including potential penalties for violations, is essential to fully utilizing the E-ZPass system and avoiding unexpected fees.

Documents used along the form

The E-ZPass MA Application form is an essential document for individuals wishing to establish an electronic toll collection account in Massachusetts. Along with this application, several other forms and documents are commonly required. Understanding these can help streamline the process and ensure a successful application.

  • Vehicle Registration Document: This document serves as proof of vehicle ownership or leasing. It lists the details of the car, including the make, model, and license plate number. Providing this ensures that the vehicle is registered correctly with E-ZPass.
  • Bank Account Information: If you choose the direct payment option from your checking account, you'll need to submit routing and account numbers. This allows E-ZPass to automatically replenish your balance when it gets low.
  • Credit/Debit Card Information: If you prefer to use a credit or debit card for automatic replenishment, you'll need to provide your card details. This is critical to ensure that your account remains funded to cover tolls.
  • Authorization Form (for Direct Debit): This form allows E-ZPass to withdraw funds automatically from your indicated bank account or card. Signing this is necessary for uninterrupted service and account funding.

These supplemental documents work together with the E-ZPass MA Application to establish a seamless toll payment solution. It’s important to gather all required information in advance to avoid delays in account activation.

Similar forms

The E-ZPass Massachusetts application form is similar to several other application documents. Here are six comparable documents, along with their similarities:

  • Driver's License Application: Both require personal identification information such as name, address, and contact details to authorize the issuance of a permit or transponder.
  • Vehicle Registration Form: Like the E-ZPass form, this document collects vehicle identification details, including make, model, and license plate number.
  • Insurance Application: Both include clauses that require the applicant to provide personal information and authorize payments connected to ongoing services.
  • Bank Account Opening Form: Similar to the E-ZPass application, this form includes bank routing numbers and account numbers for automated payments.
  • Membership Application for Toll Facilities: This document gathers similar vehicle and personal information aimed at facilitating account management for toll payments.
  • Credit Card Application: Both the E-ZPass form and credit card applications require identification information and authorize the service provider to charge fees against an account.

Dos and Don'ts

  • Do print clearly when filling out the application to ensure all information is legible.
  • Do check the correct vehicle type and license plate for accurate account setup.
  • Do provide an email address to receive your monthly account statements electronically.
  • Do list at least one vehicle per transponder requested to avoid processing delays.
  • Don't forget to update your account information if there are any changes to your vehicles or personal details.
  • Don't send cash or checks by mail without ensuring you have included your initial payment if required.
  • Don't skip providing a contact number, as this can delay customer service responses.
  • Don't use a vehicle not listed on your application to avoid violation fees.

Misconceptions

The E-ZPass Massachusetts Application form can lead to several misconceptions. Here are five common misunderstandings, along with clarifications for each.

  1. Misconception 1: The application is only for cars.

    In reality, this application is specifically designed for privately owned or leased 2- and 4-axle vehicles. Those operating vehicles with more than 4 tires or livery vehicles must obtain a different application.

  2. Misconception 2: You can submit any amount of vehicles on one application.

    Applicants must list at least one vehicle corresponding to each transponder requested. The application will not process without this information.

  3. Misconception 3: E-ZPass accounts are free to maintain.

    There is a $2.00 monthly fee for certain services. It is essential to understand any charges incurred when enrolling in the E-ZPass program.

  4. Misconception 4: You can use the E-ZPass lane with any vehicle, regardless of registration.

    Only vehicles that have been listed and approved in the account may use designated E-ZPass lanes. Using an unauthorized vehicle can lead to fines and penalties.

  5. Misconception 5: Once signed up, an E-ZPass account does not require any updates.

    Changes to personal information or vehicles must be reported. Maintaining accurate records is crucial in avoiding potential fines and violations.

Key takeaways

Key Takeaways for Completing and Using the E-ZPass MA Application Form

  • Clear Information Required: It’s crucial to print your personal information clearly. This includes your name, address, and vehicle details. Providing accurate information will help avoid delays in processing your application.
  • Transponder Limits: You can request up to four transponders per account. Make sure to list all vehicles that will use these transponders, as each must be registered properly.
  • Payment Options: Choose your preferred payment method carefully. You can opt for automatic replenishment through a bank account or credit/debit card, or select manual payments. Be aware that a low balance can lead to violations and fines.
  • Regular Updates Necessary: Always keep your account updated with any changes in your vehicle or personal information. Failing to do so could result in penalties or issues with transactions.

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