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Instructions

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SECTION 1 - Type of Account and Number of PIKEPASS Tags Requested

Account Types:  Please indicate the type of account requested. Specify the number of PIKEPASS Tags you want assigned to your account:

  1. Commuter Accounts: The person who signs the application assumes financial liability for the Pikepass account.
    • A Minimum Prepaid License and Toll Fee of $40.00 is required to open this type of account. This entitles commuter customers up to three Tags initially. Additional Tags requested require a Minimum Prepaid License and Toll Fee of $40.00 per every three tags requested.
    • Accounts requesting 10 or more Tags will be opened as Commercial Accounts.
  2. Commercial Accounts: To open a Commercial Account, the customer must provide copies of the following: a written authorization from the proper authority (someone who can assume liability for the company) on company letterhead, listing contact names and the company’s Federal Tax ID Number. (Otherwise it will be opened as a commuter account.)
    • A Minimum Prepaid License and Toll Fee of $80.00 is required to open this type of account. This entitles commercial customers up to three Tags initially. Additional Tags requested require a Minimum Prepaid License and Toll Fee of $80.00 per every three tags requested.
  3. Government Accounts: Please call the Government Accounts Representative at the PIKEPASS Customer Service Center for assistance.
     

SECTION 2 - Responsible Party Information


  1. Company Name:  The Company’s business name and Federal Tax ID number are required for commercial accounts. The Application will be returned if not included.
  2. Name:  Your complete legal name and driver license number is required.
  3. Mailing Address:  Your complete mailing address is required. Please include street designators (e.g. ST, AVE, RD. and APT #).
  4. Email Address:  This is an option you choose for your statement and notice delivery method. Email is 5 days faster than regular mail.
  5. Phone Numbers:  Provide a number you may be reached during the daytime and evening. A work phone number is required for Commercial Accounts.
  6. Account Access Code:  Provide a four-(4) digit number to control and secure access to your account information and toll transactions. Changes to your PIKEPASS account, and/or any account information will only be provided to you (the individual account holder), or any person(s) you provide the Account Access Code.

SECTION 3 - Payment Options

Method of Payment Choose only one option.

A credit/debit card, voided check, or cash deposit is required to open an account. If you apply for a Pikepass Account, in person, at one of our designated Customer Service Agents or by facsimile, your initial Minimum Prepaid License and Toll Fee must be made by credit/debit card. If you apply for a Pikepass account by mail and you request a payment option other than Credit Card (Auto Charge), you must enclose a check or money order for your initial Minimum Prepaid License and Toll Fee. A credit card or cash deposit ($30.00 per Tag requested) must be provided to secure all Cash/Check/Money Order (Manual Replenishment) accounts. Failure to maintain the credit card security or cash deposit on all Cash/Check/Money Order accounts will result in termination of the License Agreement.

  1. Credit/Debit Card (Auto Charge): If you would like your credit/debit card automatically charged, mark the Credit Card (Auto Charge) box on the application. Include your credit card number and expiration date. Please write your name and sign as it appears on the credit card. Credit Card Accounts will be replenished automatically by charging your authorized credit card when your Pikepass account reaches a balance of $10.00 for Commuter accounts or 1/3 of the Minimum Prepaid License and Toll Fee for Commercial Accounts.
  2. Direct Debit Bank Draft/EFT (Auto Charge): If you would like your bank account debited directly, mark the Direct Debit Bank Draft/EFT box on the application. You must complete the Direct Debit Bank Draft Information, including Bank Name, Address, Phone #, Account #, and Transit/ABA#. Bank Draft Accounts will be replenished automatically by debiting your designated bank account when your Pikepass account reaches a balance of $10.00 for Commuter accounts or 1/3 of the Minimum Prepaid License and Toll Fee for Commercial Accounts.
  3. Cash/Check/Money Order (Manual Replenishment):If you would like to be billed when your account falls below a certain amount, mark the Cash/Check/Money Order box on the application. A credit/debit card or cash deposit ($30.00 per Tag requested) must be provided to secure all Cash/Check/Money Order accounts. The security credit/debit card is only charged when your account is overdrawn for more than 30 days, immediately prior to your account being suspended. If you keep your account in good standing, we will not charge your security credit/debit card. Please write your name and sign as it appears on the credit/debit card. Cash/Check/Money Order accounts will receive a “Payment Request” when the account reaches a balance of $15.00 for Commuter accounts or 1/3 of the Minimum Prepaid License and Toll Fee for Commercial Accounts. You are required to replenish your Cash/Check/Money Order account by remitting the amount requested. Payments must be received before your account balance reaches zero.

SECTION 4 - Itemized Statement of TOLL Usage

Pikepass Account Statements are mailed to you either quarterly or monthly, depending upon which option you choose. If you don’t choose a statement frequency option, we will mail your statements quarterly. These statements detail all account transactions as well as toll usage. If you do not have activity on your account, we will not mail a statement. Duplicate statements, if requested within 30 days from your last statement, are available free of charge. A duplicate statement requested later than 30 days after the statement date cost $5.00 per statement.

SECTION 5 - Vehicle Information

To help eliminate billing errors and possible toll violations, this section must be completed carefully. Verify your license plate number and vehicle axle counts before the application is processed. You must list anything that may be towed, including boats, trailers and cars. These may affect vehicle classification. Vehicle descriptions are required for each Tag issued. You must have a license plate number for each vehicle listed. If you do not have a license plate number, a Pikepass Tag cannot be issued.

Please Remember:

  • A Credit/Debit Card or voided check is required to open all accounts.
  • If you apply for a PIKEPASS Account, in person, at one of our designated Customer Service Agents or by fax, your initial Minimum Prepaid License and Toll Fee must be made by credit/debit card.
  • If you apply for a PIKEPASS account by mail and you request a payment option other than Credit Card (Auto Charge) you must enclose a check or money order for your initial Minimum Prepaid License and Toll Fee.
  • A credit/debit card or cash deposit ($30.00 per Tag requested) must be provided to secure all cash accounts.
  • Failure to maintain the credit/debit card or cash deposit security on all cash accounts will result in termination of the License Agreement.

If you need additional information related to the Application/License Agreement, please call or stop by either of our Customer Service Centers.