Homepage Blank E Zpass Ma Application PDF Template
Navigation

Applying for an E-ZPass MA Account simplifies travel for residents and frequent visitors to Massachusetts with privately owned or leased 2-axle, 4-tire vehicles. With the option to mail or fax applications to the E-ZPass MA Customer Service Center in Auburn, Massachusetts, or to join online, convenience is a key aspect of this system. Personal information, vehicle details, and transponder requests are crucial elements of the application process, designed to ensure accurate toll collection and account management. Importantly, the form outlines various toll payment options such as direct payment from a checking account, direct payment from a credit/debit card, or manual account replenishment, allowing users to choose the method that best fits their financial preferences. In addition to providing authorization for automatic account deductions when the balance falls below a certain threshold, the application form serves as an agreement to the program's terms and conditions. These terms cover a wide range of topics including the use of E-ZPass transponders, account management, violation penalties, dispute resolution, and data privacy, ensuring that users are well-informed about their responsibilities and rights as E-ZPass MA account holders. This comprehensive approach ensures a smooth and efficient toll-paying process, emphasizing the importance of keeping personal and vehicle information up to date to avoid potential complications.

Preview - E Zpass Ma Application Form

®

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

Form Data

Fact Name Fact Information
Eligibility for Individual Account The application is for privately owned or leased 2-axle, 4-tire vehicles only. Owners of vehicles not meeting these criteria need to pursue a Commercial Business Account.
Contact Information For application submission or inquiries, contact the E-ZPass MA Customer Service Center at 27 Midstate Drive, Auburn, Massachusetts 01501-1839 or call 1-877-627-7745.
Online Application Option Applicants wishing to join the E-ZPass MA program can also apply online at www.mass.gov/ezpassma.
Monthly Statement Options Applicants can choose not to receive a monthly account statement, to receive an email link to the statement, or to have the statement mailed with a $2.00 monthly fee.
Governing Law The E-ZPass MA program agreement and usage are governed by the laws of the Commonwealth of Massachusetts. Legal proceedings must be brought in Superior Court, Suffolk County in Boston, Massachusetts.

Instructions on Utilizing E Zpass Ma Application

Successfully joining the E-ZPass Massachusetts program and obtaining your transponder involves filling out the application form correctly. This process ensures your toll transactions are conveniently automated, allowing smoother travel across toll roads in Massachusetts. Here are the steps to fill out your E-ZPass MA Application form:

  1. Start by heading to the official website provided or call the number listed if you prefer to request a physical form.
  2. Under Personal Information, write your full name (Last, First, Middle Initial) as it appears on your vehicle registration.
  3. Choose your statement option. If you opt for electronic statements, make sure your email address is accurately entered.
  4. Provide your complete address, including city, state, and zip code, along with your contact information (home, work, cell phone, and fax numbers).
  5. For your 4 DIGIT PERSONAL PIN NUMBER, select any four numbers that you can easily remember. This PIN will be essential for accessing your account information online or by phone.
  6. In the Vehicle Information section, list all vehicles that will be using the E-ZPass MA. Include the license plate number, plate type, state, and details about the vehicle's make, model, and year. Also, indicate if any of the vehicles are leased.
  7. Decide on the number of transponders you require. A maximum of four transponders is allowed per account.
  8. Select your preferred Toll Payment Option. If you choose direct payment from a checking account or credit/debit card, provide the necessary account information. Manual account replenishment requires maintaining a pre-paid balance, and initial payment should be included if mailing your application.
  9. Review the Authorization section carefully. By signing, you confirm that you've read and agreed to the terms and conditions, including your chosen payment method.
  10. Finally, complete the application by dating and signing at the bottom of the form. This signature is crucial for validating your application.

Once you have completed all the steps, mail or fax your application to the address or number provided. After processing, you'll receive your E-ZPass transponder(s) and can start enjoying the convenience of automated toll payments. Remember, maintaining accurate and up-to-date information on your account is vital for smooth operation and to avoid unnecessary charges or penalties.

Obtain Answers on E Zpass Ma Application

Access to accurate information simplifies the process of applying for an E-ZPass MA account. The FAQs compiled below aim to provide insightful and practical guidance for those interested in navigating the application process seamlessly.

  1. How can I apply for an E-ZPass MA account?
  2. The application process for an E-ZPass MA account has been designed for both convenience and accessibility. Individuals seeking an E-ZPass for privately owned or leased 2-axle, 4-tire vehicles can either mail or fax their application to the E-ZPass MA Customer Service Center located at 27 Midstate Drive, Auburn, Massachusetts 01501-1839. Fax submissions can be sent to 1-508-786-5222. Alternatively, applications can be completed online at www.mass.gov/ezpassma, offering a streamlined option for those who prefer digital convenience. It's crucial to note that vehicles with more than 4 tires, or those used for commercial purposes, need to undergo a different application process, which can be initiated by calling 1-877-627-7745 and selecting Option 3 followed by Option 7.

  3. What information is required to apply for an E-ZPass MA?
  4. When applying for an E-ZPass MA, applicants are asked to provide comprehensive personal and vehicle information to ensure a smooth registration process. Required details include a personal identification section that covers basic contact information and a vehicle information section that encompasses specifics like license plate number, plate type, state, make & model of the vehicle, and the year of manufacture. It’s also mandatory to create a 4-digit personal identification number (PIN) to secure access to account information online or over the phone. This thorough approach guarantees that all necessary data is obtained to link the applicant’s vehicle(s) to their E-ZPass account effectively.

  5. What are the toll payment options available with E-ZPass MA?
  6. E-ZPass MA provides multiple convenient toll payment options to accommodate the preferences of diverse users:

    • Option B: Direct payment from a checking account, which authorizes E-ZPass MA to initiate debit entries to replenish the account balance automatically whenever it falls below a predetermined threshold.
    • Option C: Direct payment from a credit/debit card allows for the automatic replenishment of the E-ZPass account using the provided card details.
    • Option D: Manual account replenishment requires the account holder to monitor and manually replenish their account balance to ensure it covers toll costs and avoids falling into a negative balance.
    Each option has been designed to offer flexibility and control over how toll payments are managed, catering to the varied needs of E-ZPass users.

  7. What happens if I lose my transponder or if it's stolen?
  8. In the event of a lost or stolen transponder, it is imperative to contact the E-ZPass MA Customer Service Center immediately. Until the Center is notified, the account holder may be responsible for any costs incurred through the use of the transponder. Upon notification, steps will be taken to deactivate the missing transponder and issue a replacement if necessary. This prompt response helps to prevent unauthorized toll charges and ensures that the account holder’s E-ZPass service is minimally disrupted.

Common mistakes

  1. Filling out the application with incorrect vehicle information is a common mistake. The E-ZPass MA application specifies that it is for privately owned or leased 2-axle, 4-tire vehicles only. Including vehicles that do not meet these criteria, such as those with more than 4 tires, or commercial vehicles, requires a different application process.

  2. Choosing more than one statement option for receiving the monthly account statement. Applicants must choose only one method of receiving their statement – either none, email, or postal mail. Selecting more than one can lead to confusion and processing delays.

  3. Not providing a valid 4-digit personal identification number (PIN). This PIN is essential for accessing account information online or via phone. Skipping this step or entering an invalid number compromises account security and access.

  4. Including inaccurate or incomplete bank or credit/debit card information for toll payment options. Whether choosing direct payment from a checking account or direct payment from a credit/debit card, it's crucial to double-check bank routing numbers, account numbers, and card numbers for accuracy. Inaccurate or incomplete financial details can delay the activation of the E-ZPass.

  5. Omitting the signature and date at the end of the application. This oversight is more common than one might think. A missing signature or date can invalidate the entire application, as it indicates that the applicant has not authorized the submission or agreed to the terms and conditions.

Documents used along the form

When applying for an E-ZPass MA account, individuals commonly encounter the need for various other forms and documents to ensure a smooth and timely processing of their application. Understanding these additional documents can help applicants prepare more efficiently and avoid potential delays in receiving their E-ZPass transponders.

  • Vehicle Registration Document: A copy of the vehicle registration document is crucial as it verifies the ownership and eligibility of the vehicle for an E-ZPass. It provides essential details like the make, model, year, and license plate number.
  • Proof of Residency: Applicants may be required to show proof of residency within Massachusetts or a participating E-ZPass state. This could be in the form of a utility bill, lease agreement, or a state-issued identification card showing the applicant's current address.
  • A voided check or bank statement: If opting for the Direct Payment from Checking Account option (Option B), applicants need to provide a voided check or a bank statement. This document is necessary to verify the bank account details for setting up automatic toll payments.
  • Credit/Debit Card Information: For those choosing the Direct Payment from Credit/Debit Card option (Option C), a form containing credit or debit card information is required. It must include the card number, expiration date, and cardholder's name to ensure automatic toll payment replenishment.

Completing the E-ZPass MA application along with these supplemental documents not only enhances the efficiency of the processing but also aligns with the Massachusetts Department of Transportation's requirements. Applicants are encouraged to gather these documents beforehand to ensure a seamless application process for their E-ZPass MA account, which facilitates convenient and quick passage through tolls. Understanding and preparing these documents in advance reflects a proactive approach toward a smooth and efficient toll payment process.

Similar forms

  • Bank Account Application Forms: Similar to the E-ZPass MA Application form, bank account applications require personal information, payment option selections, and agree to terms and conditions. Both involve choosing how the account will be managed financially (e.g., automatic withdrawals, low balance alerts), and users must provide authorization for these transactions.

  • Rental Car Agreements: These documents, much like the E-ZPass application, ask for personal details, vehicle information, and method of payment. Both set forth terms and conditions governing the use of the service, including responsibilities for damages, fines, or additional charges, and stipulate how disputes are resolved.

  • Credit/Debit Card Applications: These forms also collect personal and financial information and require applicants to choose from various billing options. Similarly, they include terms and conditions that applicants must agree to, relating to usage, liabilities, fees, and account management.

  • Mobile Phone Service Contracts: Like the E-ZPass MA Application, mobile service contracts require customer details, account settings (for billing and usage), and a signed agreement to adhere to specified terms and conditions. Both involve choosing service plans and may include provisions for automatic account top-ups or fees for services used beyond the plan's scope.

Dos and Don'ts

When filling out the E-ZPass MA Application form, applicants should approach the process with attention to detail to ensure accurate and timely processing. Below are essential dos and don'ts to guide you through the application process:

  • Do ensure that all personal information provided matches exactly with what is on your vehicle registration to avoid any discrepancies.
  • Don't leave out any vehicle that will be using the E-ZPass transponder; ensure all vehicles are listed with their corresponding license plate numbers and states.
  • Do choose a Personal Identification Number (PIN) that you can easily remember but is hard for others to guess to secure your account information.
  • Don't select more transponders than you actually need. Remember, the maximum number of transponders per account is four.
  • Do thoroughly read through all terms and conditions related to the E-ZPass system and your obligations as an account holder to ensure compliance.
  • Don't forget to sign the application form. An unsigned application cannot be processed, delaying the issuance of your transponder(s).
  • Do consider the payment option that best suits your financial situation, whether it's direct payment from a checking account, credit/debit card, or manual account replenishment.
  • Don't ignore the importance of immediately updating your account with any changes or additions to vehicle(s) or personal information to maintain account accuracy.

By adhering to these guidelines, applicants can ensure a smoother process in obtaining and managing their E-ZPass MA account, contributing to a more convenient travel experience across Massachusetts's toll roads.

Misconceptions

When discussing the E-ZPass MA application form, several misconceptions commonly arise. Clearing up these misunderstandings can help applicants better navigate the process and ensure their applications are completed correctly.

  • Misconception 1: The application is only available for vehicles with Massachusetts license plates. In reality, the E-ZPass MA program is available to owners of privately owned or leased 2-axle, 4-tire vehicles, regardless of the state where the vehicle is registered. This misunderstanding could prevent eligible applicants from other states from taking advantage of the program.

  • Misconception 2: You need to visit an office to apply. Contrary to this belief, applicants have multiple options for submission, including mail, fax, or online through the official website. This flexibility is designed to make the application process more convenient for all applicants.

  • Misconception 3: Email communication is not an option for receiving monthly statements. The application form clearly provides an option for customers to receive their statements via email, addressing concerns about postal delays or environmental impact.

  • Misconception 4: Automatic account replenishment is the only payment option. While automatic replenishment is encouraged for its convenience, the application form offers multiple payment options including direct payment from a checking account, credit/debit card payment, or manual account replenishment, thus accommodating different preferences and financial situations.

  • Misconception 5: Commercial vehicles cannot be registered. While the standard application is for 2-axle, 4-tire vehicles only, operators of vehicles with more than four tires or commercial license plates can apply for a Commercial Business Account by contacting customer service. This distinction ensures that businesses with commercial vehicles can utilize E-ZPass for their specific needs.

  • Misconception 6: The application process is complicated. The form is designed to be straightforward and user-friendly, with clear instructions and the option for assistance over the phone, dispelling the notion that applying for E-ZPass MA is a burdensome process.

Understanding these misconceptions can lead to a smoother application process for potential E-ZPass MA users, ensuring they can take full advantage of the program's benefits without unnecessary confusion or hassle.

Key takeaways

  • Completing the E-ZPass MA Application is essential for users of privately owned or leased 2-axle, 4-tire vehicles. Those with vehicles that don't fit this description, such as ones with more than four tires or with commercial license plates, must pursue a Commercial Business Account.
  • Applicants must provide a wide range of personal information, including a special 4-digit PIN for secure account access online or via phone. This underscores the importance of safeguarding personal data even in seemingly straightforward applications like for toll collection.
  • The application offers multiple statement options, allowing users to choose how they receive their monthly account statements - via mail, email, or online. This flexibility caters to different preferences and needs, offering a glimpse into the user-focused design of the E-ZPass MA system.
  • Vehicle information is a critical component of the E-ZPass MA Application, highlighting the necessity of linking each transponder request to a specific vehicle. This requirement reinforces the system's aim at streamlining toll payments while ensuring accurate vehicle identification and accountability.
  • The application specifies a limit of four transponders per account, shaping a boundary for individual users. This limit points to the program's intention to balance accessibility with control, preventing abuse while accommodating typical family or small business needs.
  • Several toll payment options are presented, including direct payments from checking accounts or credit/debit cards, or manual account replenishment. This range of options is indicative of an effort to accommodate diverse financial preferences and situations, allowing users to choose the method that best aligns with their fiscal management styles.
  • The application is not just a formality but a legally binding agreement between the applicant and MassDOT, covering terms of use, transponder management, account maintenance, and privacy issues. This underscores the legal responsibilities assumed by both parties, emphasizing the importance of understanding and adhering to these terms to ensure a beneficial relationship.
Please rate Blank E Zpass Ma Application PDF Template Form
4.65
Incredible
17 Votes