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The Metrocard Application Form is a vital document for Senior Citizens aged 65 and older seeking to take advantage of reduced-fare transportation options. This form collects essential information such as your name, address, date of birth, and proof of age documentation to verify eligibility. To complete the application process, a recent photograph that meets specific size requirements must be included. It's important to provide accurate details on each section of the form, as incomplete submissions will delay processing or result in rejection. If assistance is needed, help is just a phone call away at 718-330-1234, or you can visit the NYC Transit Reduced Fare Service Center for in-person support. Additionally, it's crucial to understand that all information is confidential and only used to determine eligibility. The application does not require notarization if submitted in person, but it does necessitate clear proof of age, such as a driver's license or Medicare card. Fully understanding the Metrocard Reduced-Fare Program entails acknowledging the conditions of use; misuse can lead to cancellation of privileges. After submission, applicants should allow two to four weeks for processing and ensure their personal information remains up to date, particularly when it comes to changes in address or reporting lost cards.

Metrocard Application Example

Application for MTA Reduced-Fare MetroCard for Senior Citizens (65 years or older)

ALL INFORMATION WILL BE KEPT STRICTLY CONFIDENTIAL

General Information — If you receive Medicare Benefits based on a Disability, use the application for People with Disabilities.

2"

1 1/2"

Recent photo must fit in the space provided

For telephone assistance in completing this application and for answers to questions about it, call 718 330-1234. If you are unable to complete the form yourself, it can be completed by anyone you choose to assist you or you can visit our NYC Transit Reduced Fare Service Center located at 3 Stone Street in downtown Manhattan, Monday to Friday 9 a.m. to 5 p.m. or MetroCard Bus to apply in person. You must bring an official ID with your birth date indicating that you are a Senior Citizen 65 years or older. You do not need this application notorized when you appear in person. A photo will be taken.

All information provided by you will be used solely for the purpose of determining your eligibility for the reduced-fare transportation.

Every question on this application must be answered. Incomplete applications or applications submitted without photographs and a copy of proof of age documentation will be returned to you.

Allow two to four weeks for processing.

If you are mailing this application, you must submit a recent photograph. Please write your name on the back of the photograph. The photograph must be at least two inches high and one-and-a-half inches wide (2"x 1 1/2") with a solid background showing a full front view of your face. Please see diagram at left.

Request Type

 

n New Applicant

 

 

 

 

n EasyPay

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Customer

 

Type or print in ink and sign where indicated.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name

First Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M.I.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Apt. No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City/Borough

 

 

 

 

 

 

 

 

 

 

 

State

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Home Telephone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Work/Other Telephone

Date of Birth

Your Social Security Number (optional)

1

mta.info

Code

Male Female Unspecified

mta

Please attach proof of age documentation;

A photocopy of one of the following is required (check box):

n Birth Certificate

n

n Valid State ID

n

Driver’s License

PassportOR

nMedicare Card

If you are a Senior Citizen

65 years or older.

Applications submitted without copy of proof of age documentation will be returned to you.

Notary Public

Must be completed for all applicants, except when applying in person with photo ID.

Affirmation

State of __________________________________________________ }

ss :

County of _________________________________________________ }

On this ______________ day of _______________, 20 ________ before me appeared

_____________________________________________________________________________

to me known and known to me to be (Check the one that applies.)

nthe person who is described in and who executed the foregoing instrument

nthe personal representative of the applicant named above and who executed the foregoing instrument on behalf of the applicant.

and (s)he duly acknowledged to me that (s)he executed the same and that the statements therein are true.

Signature and stamp of officer _________________________________________

NOTARY PUBLIC

I am a senior citizen 65 years or older. I affirm under penalty of perjury that all statements made on this application, which the Metropolitan Transportation Authority relies on to determine my eligibility status, are true and complete. I have read and understand all the information contained in this application. I understand that all statements made in this application may be subject to investigation and verification and that a material misstatement or fraud will disqualify me for reduced-fare privileges.

I understand that the MTA may discontinue or change its reduced-fare program without notice. If the MTA should find that I have not followed the Reduced-Fare Program Conditions of Use, I understand that my Reduced-Fare MetroCard will be cancelled and I will not be eligible to reapply for the reduced-fare program.

I understand that it is a crime to allow anyone else but me to use the MTA Reduced-Fare MetroCard.

By signing this application I (1) acknowledge that I have read the enclosed Conditions of Use for MTA Reduced-Fare MetroCard and (2) accept and agree to be bound by such conditions of use.

Applicant’s

Signature X ____________________________________________________________ Date ________________

or Personal Representative ________________________________________________ Date ________________

(print name)

2

158_18, Revised May 2018

The EasyPay OptionSign up for EasyPay automatic refills

(All payment information will be kept strictly confidential.)

Start paying for your rides with $10. Your account will be automatically replenished whenever the balance goes below $10. Your account immediately converts to unlimited rides when the required number of subway or local bus rides is taken within a 30-day billing period.

Questions? Call 1-877-323-7433

nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn

First Name

nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn

Last Name

 

 

 

nn nn nnnn

 

nnn nnn nnnn

Date Of Birth

 

Telephone n Home nwork nother

Payment Options (choose one)

o Credit

o Debit Card

n American Express

n Discover

n MasterCard

n Visa

n n n n n n n n n n n n n n n n

nn / nn

Credit/Debit Card Number

 

 

Expiration Date

I authorize MTA New York City Transit to charge this credit/debit card for my EasyPay MetroCard refills.

Signature

Date

Card holder signature (if different)

Applications without Credit/Debit Card authorization signature will be returned to you.

I am a visually impaired customer and wish the following statement:

(check one)

o Large Type

o Braille

For further information or additional copies of the application, call 718-330-1234. If you are deaf or hard of hearing, use the free 711 relay or your preferred relay service provider to contact us. Or visit mta.info

Before Mailing the Application include:

Mail completed application to:

1 – A recent photograph

Metropolitan Transportation Authority

2 – A copy of proof of age or Medicare Card

Reduced-Fare Program

3 – A Notary Public

130 Livingston Street

4 – Affirmation Signature (page 2)

Brooklyn, New York 11201-9625

 

 

For Office Use Only

Disk # ________________________________________________________________ Image # _____________________________________

Examiner’s Signature _______________________________________________________________________________________________

3

mta

MTA Reduced-Fare MetroCard

Conditions of Use and Other Important Information

for a Metropolitan Transportation Authority Reduced-Fare MetroCard (RFM) issued to people 65 years of age and older and people with disabilities. This program is managed by MTA New York City Transit.

Valid Use: RFM can be used to pay fares on all MTA New York City Transit subways, NYC Transit local buses, express buses only during non rush hours, MTA Staten Island Railway, Nassau Inter-County Express Bus (NICE), MTA Bus, Roosevelt Island Tram, Westchester Bee-Line local buses and express Bee-Line BxM4C buses only during non rush hours.

The RFM is valid identification for eligibility in the reduced- fare programs of the MTA Long Island Rail Road and MTA Metro-North Railroad, anytime except weekday rush hours to New York City terminals. To receive the reduced fare, show the RFM to train personnel or station agents when purchasing your ticket.

Expiration Dates: Reduced-Fare MetroCards expire on the date printed on the back of the card. As long as you actively use your card, NYC Transit automatically sends you a new RFM before the expiration date.

The full value on an expired RFM may be transferred to a new RFM at a subway station booth. Any remaining value that is not transferred to a new RFM within two years after the expiration date on the original RFM will be surrendered by, and unavailable to, the card holder.

Trouble Using RFMs: An RFM that does not work or is damaged should be returned to MetroCard Customer Claims. Ask a station booth agent or bus operator for a prepaid envelope in which to return your card to us. In the envelope you’ll find a form to fill out so you can describe your RFM problem.

If you prefer, you may bring your damaged RFM to the MetroCard Customer Service Center at 3 Stone Street in downtown Manhattan, 9 AM to 5 PM, Monday to Friday.

If you cannot get a prepaid mailer, send the damaged card to our mailing address at:

MetroCard Customer Claims

130 Livingston Street

Brooklyn, New York 11201-9625

Be sure to include your name, address and phone number, your damaged RFM, an explanation of the problem and the address to which the new RFM should be sent.

The holder assumes the risk of loss until the card is received by either MetroCard Customer Claims or the MetroCard Service Center.

Change of Address: Notices and replacement cards will be sent to you at the address you provide. You must inform us promptly, in writing, of any change of address.

Lost or Stolen RFMs: Immediately report a lost or stolen RFM by calling the MetroCard Customer Service Center, 718-330-1234, 6 AM to 10 PM or via our MetroCard eFIX system at www.mta.info. Any value or unlimited rides on your card will be transferred to your replacement RFM after the old RFM has been frozen and any balances verified.

Restrictions: An RFM may be used only by the person to whom it has been validly issued. Use of the RFM by any other person may result in forfeiture of the card and its remaining balances, plus civil and/or criminal penalties.

You must present your Reduced-Fare MetroCard to a police officer or transit personnel upon request.

There are no refunds of money remaining on RFMs. Money remaining on an expired card may only be transferred to a new card within two years of the expiration date. Money from a full-fare MetroCard cannot be transferred to a temporary or permanent RFM. No redemptions or exchanges will be given for an RFM that has been altered or tampered with, or whose value cannot be verified.

The City of New York, the State of New York, the County of Westchester and the Metropolitan Transportation Authority and its subsidiaries and affiliates, including New York City Transit, are not liable for any special or consequential damages associated with or resulting from the failure, malfunction, or disabling of the RFM or the MetroCard system.

The MTA Reduced-Fare MetroCard and its use are subject to all tariff provisions, rules and regulations of the New York City Transit Authority and its affiliates, and Westchester County Bee-Line System.

For more information, call 718-330-1234 6 AM to 10 PM. If you are deaf or hard of hearing, use the free 711 relay or your preferred relay service provider to contact us. Have the card at hand so you can read the serial number and expiration date to the customer service agent who assists you.

4

158_18_Sen Appl., Revised May 2018

mta

Form Characteristics

Fact Name Description
Eligibility Criteria Individuals must be 65 years or older to apply for the MTA Reduced-Fare MetroCard. Proof of age is required with the application.
Application Submission Applications must include a recent photograph and proof of age documentation. Incomplete applications will be returned.
Notary Requirement While a notarization is generally needed for applications, seniors applying in person with valid ID do not require a notary.
Processing Time Applications typically take two to four weeks for processing. Applicants mailing in their forms must ensure all requirements are met.
Governing Laws The application process is governed by the Metropolitan Transportation Authority (MTA) regulations and New York State law.

Guidelines on Utilizing Metrocard Application

Filling out the Metrocard Application form requires attention to detail to ensure the application is processed smoothly. Submitting a complete application will expedite your request for a reduced-fare MetroCard. Below are clear steps to assist you in completing the form accurately.

  1. Obtain the Metrocard Application form from the MTA website or request a hard copy.
  2. Fill out the "Request Type" section by marking either "New Applicant" or "EasyPay Customer."
  3. Provide your personal information in the spaces provided, including:
    • Last Name
    • First Name
    • Middle Initial
    • Street Address
    • Apt. No. (if applicable)
    • City/Borough
    • State
    • Zip Code
    • Home Telephone
    • Work/Other Telephone
    • Date of Birth
    • Social Security Number (optional)
  4. Select your gender by checking the appropriate box.
  5. Attach proof of age documentation, choosing one of these options:
    • Birth Certificate
    • Valid State ID
    • Driver’s License
    • Passport
    • Medicare Card
  6. Include a recent photograph, ensuring it measures 2 inches high by 1.5 inches wide with a solid background. Write your name on the back of the photograph.
  7. Complete the Notary Public section only if you are not applying in person.
  8. Sign the application where indicated, affirming your eligibility for the program.
  9. Review the entire application to verify that all sections are completed and accurate.
  10. Prepare to mail the application. Include:
    • The completed form
    • A recent photograph
    • A copy of proof of age documentation
    • The Notary Public section (if applicable)
    • Your signature in the affirmation section
  11. Mail your application to: Metropolitan Transportation Authority, Reduced-Fare Program, 130 Livingston Street, Brooklyn, New York 11201-9625.

Once your application is processed, you can expect a follow-up within two to four weeks. Ensure you keep an eye out for any communication from the MTA regarding your application status. If you need assistance, don't hesitate to reach out to their helpline at 718-330-1234.

What You Should Know About This Form

What is the MetroCard Application for Reduced-Fare MetroCard?

The MetroCard Application allows senior citizens aged 65 or older to apply for a Reduced-Fare MetroCard. This card offers discounted rates for public transportation services provided by the MTA, including subways and buses. It's a great way for seniors to save money on their daily commutes or leisure travel throughout New York City.

How can I apply for the Reduced-Fare MetroCard?

You have two options for applying: You may complete the application form and mail it in, or you can apply in person at the NYC Transit Reduced Fare Service Center located at 3 Stone Street, Manhattan. When applying in person, bring an official ID with your birth date showing you are at least 65 years old, and a recent photograph.

What documents do I need to submit with my application?

When submitting your application, you must include a recent photograph (2" x 1.5") and a copy of proof of your age. Acceptable forms of proof include a birth certificate, valid state ID, driver’s license, passport, or Medicare card. Applications submitted without these documents will be returned.

Is there a fee associated with the MetroCard Application?

There is no fee to apply for the Reduced-Fare MetroCard itself; however, you will need to pay for the card and the trips you take once you receive it. The card provides discounts on transportation fares, helping you save money.

How long does it take to process my application?

You should allow two to four weeks for processing your application. If you're applying in person at a service center, the process might be quicker since you can receive assistance on the spot.

What should I do if my Reduced-Fare MetroCard is lost or stolen?

Report a lost or stolen card immediately by calling 718-330-1234. This will freeze your old card and allow you to obtain a replacement card with the value transferred. Make sure to do this promptly to secure your remaining balance.

Can I use the Reduced-Fare MetroCard on all forms of MTA transportation?

Yes, the Reduced-Fare MetroCard can be used on subway services, local buses, express buses during non-rush hours, and other select MTA services. However, it is important to understand that certain restrictions may apply, particularly regarding rush hour usage on some services.

Do I need to have my application notarized?

No, if you apply in person with your photo ID and required documentation, notarization is not necessary. However, notarization is needed if submitting the application by mail without in-person verification.

What happens if I don't complete the application correctly?

Incomplete applications or those submitted without the required documents (like your photograph and proof of age) will be returned to you. It’s essential to ensure every question is answered and that you include everything before submitting to avoid delays.

Common mistakes

Filling out the Metrocard Application form can seem straightforward, but many applicants make mistakes that can delay or even prevent their applications from being processed. One common error is submitting the application without including a recent photograph. Each application requires a clear photo that meets specific size requirements: at least two inches high and one-and-a-half inches wide, with a solid background. Failing to provide a proper photo results in your application being returned.

Another frequent mistake is incomplete answers on the form. Every question must be answered, including those regarding your personal details like name, address, and date of birth. If any section is left blank, the application may be deemed incomplete. This can lead to delays, as applicants must correct the omissions and re-submit the form.

Additionally, applicants often forget to sign the affirmation section of the application. This includes acknowledging the conditions of the reduced-fare MetroCard program. Without your signature, the application cannot be processed. It is crucial to read the entire document before signing to ensure understanding and compliance with the program’s requirements.

Some individuals also overlook the importance of providing proof of age documentation. Acceptable documents include a birth certificate, valid state ID, driver’s license, or Medicare card. Submitting the application without this documentation will result in the application being returned. Always ensure that a photocopy of your proof of age is included with your application.

Moreover, failing to attach or incorrectly filling out the Notary Public section can cause significant issues. This requirement only applies if you are not applying in person. Ensure that the notary completes this section accurately, or your application will not be valid.

Another mistake applicants make involves the choice of mailing their application without proper preparation. If you are mailing your application, ensure that you include all necessary documents: a recent photograph, proof of age, and the completed application form. Concentrate on the details to prevent unnecessary delays and the hassle of reapplication.

Lastly, some people misunderstand the submission process entirely, thinking that they can submit their application at any location. In reality, applications sent by mail must go to the designated address: the Metropolitan Transportation Authority in Brooklyn. Double-check the address before sending, along with ensuring you have proper postage. Paying attention to these details can greatly streamline your application process.

Documents used along the form

The Metrocard Application form for the MTA Reduced-Fare MetroCard requires additional documentation to ensure eligibility for senior citizens or individuals with disabilities. Below are four commonly used forms and documents often submitted alongside the application. Each document plays a crucial role in the application process and helps verify the applicant’s identity and eligibility.

  • Proof of Age Documentation: A photocopy of a valid document must be included to verify that you are 65 years or older. Acceptable documents include a birth certificate, driver’s license, state ID, passport, or Medicare card. Without this documentation, the application cannot be processed.
  • Recent Photograph: It is necessary to provide a recent photo that measures at least two inches high by one-and-a-half inches wide. The photo should have a solid background and display a full front view of your face. This photo will be used for identification purposes on the MetroCard.
  • Affirmation Signature: If applying by mail and not in person, this section needs to be filled out and signed. It certifies that all the information provided is accurate and that the applicant understands the guidelines and conditions of the reduced-fare program.
  • Notary Public Form: This form serves as legal proof of the applicant's identity and truthfulness of the provided information. It must be notarized unless the applicant completes the application in person with a photo ID.

Including these forms with your Metrocard Application will help facilitate a smoother processing experience. Make sure to double-check that all required documents are attached before submitting your application to avoid delays.

Similar forms

The Metrocard Application form for the Reduced-Fare MetroCard shares similarities with several other documents that aim to gather essential information for identification or benefit eligibility purposes. Here’s a closer look at eight such documents, emphasizing their common features:

  • Application for Social Security Disability Benefits: Like the Metrocard Application, this document requires personal details, including birth dates and proof of eligibility, to determine qualification for benefits.
  • Passport Application Form: Similar to the Metrocard Application, obtaining a passport involves submitting a recent photograph, personal identification details, and proof of citizenship.
  • Driver’s License Application: This application necessitates documentation of age and identity, mirroring the Metrocard's requirements for proof of age and identity verification.
  • Voter Registration Form: Just as the Metrocard Application seeks to confirm eligibility, voter registration forms demand personal information and proof of age to ensure a valid application process.
  • Medicare Application: This document also requests proof of age and eligibility, akin to the Metrocard Application’s requirements for seniors or those with disabilities.
  • Food Stamp Application (SNAP): Both forms inquire about household information and personal identification to assess eligibility for specific benefits or programs.
  • Housing Assistance Application: Similar to the Metrocard form, housing applications require detailed personal information and often mandate proof of income or residency status.
  • College Financial Aid Application (FAFSA): This document, like the Metrocard Application, gathers personal and financial information to evaluate eligibility for financial support, often requiring corroborating documents.

Each of these documents is designed to collect necessary information to determine eligibility for specific programs, often necessitating proof of identity or age, thus illustrating a common thread in administrative processes.

Dos and Don'ts

When filling out the Metrocard Application form, there are several important steps to follow to ensure a smooth process. Below is a list of things you should and shouldn't do:

  • Do read all instructions carefully before starting the application.
  • Do provide a clear, recent photograph that meets the size requirements.
  • Do ensure that every section of the application is completed fully.
  • Do include proof of age documentation with your application.
  • Do sign your name where indicated to confirm your application is complete.
  • Don't leave any questions blank; incomplete forms will be returned.
  • Don't forget to write your name on the back of your photograph.
  • Don't attempt to use an expired Reduced-Fare MetroCard.
  • Don't let anyone else use your Reduced-Fare MetroCard, as it is solely for your use.
  • Don't mail your application without verifying that all required documents are included.

Following these guidelines can help facilitate the application process and ensure that you receive your Reduced-Fare MetroCard without unnecessary delays.

Misconceptions

Misconception 1: A notary public is required for all applications.

Many people believe that every MetroCard application must be notarized. However, this is not the case. Notarization is only necessary if you are not applying in person with valid photo identification.

Misconception 2: You cannot get help completing the application.

Another common myth is that applicants must complete the form alone. In truth, anyone can assist you with the application. If needed, visiting the NYC Transit Reduced Fare Service Center is also an option.

Misconception 3: You can submit your application without including a photograph.

Some individuals think they can send in their applications without a recent photograph. It's important to remember that every application requires a recent photo. Applications sent without a photograph will be returned.

Misconception 4: Proof of age can be shown in any format.

People often assume any form of identification will suffice for proof of age. However, the application specifies that only certain documents, like a birth certificate or valid state ID, are acceptable. Be sure to provide a photocopy of one of the listed documents.

Key takeaways

  • Eligibility: To apply for the Reduced-Fare MetroCard, you must be 65 years old or older. If you receive Medicare benefits due to a disability, use the application for People with Disabilities instead.
  • Application Completion: A family member, friend, or assistant may help you fill out the application if you cannot do it yourself.
  • Required Photo: Include a recent photo measuring at least 2 inches high by 1.5 inches wide. Write your name on the back of the photo.
  • Proof of Age: Attach a photocopy of valid proof of age, such as a birth certificate, driver's license, or Medicare card. Applications without this documentation will be returned.
  • Processing Time: Allow two to four weeks for your application to be processed once submitted.
  • Application Submission: You can submit the application by mail or in person at designated locations, including the NYC Transit Reduced Fare Service Center.
  • Affirmation Statement: An affirmation statement that confirms all provided information is true and that you understand the conditions of use must be signed.
  • No Notarization Required: If you apply in person with an official ID, the application does not need to be notarized.
  • Use of the MetroCard: The Reduced-Fare MetroCard can be used on various transportation services including subways, local buses, and more, as specified in the guidelines.
  • Lost or Stolen Cards: Immediately report a lost or stolen MetroCard to ensure your balance is transferred to a replacement card.