TA-W68176 (02/2011) New York State Thruway Authority E-ZPass Tag Order Form Motorhome/Passenger Vehicle Towing Combinations

This form is used to order an E-ZPass Tag(s) for a two or three-axle vehicle that is towing a one, two or three-axle trailer, camper, boat, etc. Tags should only be used when towing. Complete form and mail to E-ZPass New York Customer Service Center, 1150 South Avenue, Staten Island, NY, 10314 or call 1-800-333-8655. Customer Name E-ZPass Account Number Customer Signature

Instructions: Tag * ** Using the information below, check the box(es) next to the vehicle combination type Requested Special Motor TWY Tag for which you are requesting a Tag(s). (check all Towing Home that apply) CLASS Code Discount Discount

AUTOMOBILE/MINIVAN/SUV 2-Axle Car, Minivan or SUV with: A passenger car, minivan or SUV that is towing a trailer, camper, boat, etc. 1-Axle Trailer 3L 076

2-Axle Trailer 4L 080

3-Axle Trailer 4L 084

PICKUP TRUCK 2-Axle Pickup Truck with: A 2-axle 4 or 6 tire pickup truck that is towing a trailer, camper or boat using a standard hitch. 1-Axle Trailer 3L 204

2-Axle Trailer 4L 208

3-Axle Trailer 4L 210

PICKUP TRUCK Towing a 5th Wheel* 2-Axle Pickup Truck with: A 2-axle 4 or 6 tire pickup truck that is towing a trailer, camper or boat using a 5th wheel hitch. 1-Axle Trailer 3H 270

2-Axle Trailer 4H 211

3-Axle Trailer 5H 215

Proof of RECREATIONAL VEHICLE (RV) 2-Axle Motorhome with: Motorhome OR MOTORHOME ** registration is required 1-Axle Trailer 3H 460

2-Axle Trailer 4H 464

3-Axle Trailer 5H 215

RECREATIONAL VEHICLE (RV) 3-Axle Motorhome with: Proof of OR MOTORHOME ** Motorhome registration is required

1-Axle Trailer 4H 466

2-Axle Car/Trailer 5H 215

* Special Towing Discount Plan: Vehicles towing a 5th Wheel Trailer will receive a discounted rate. ** Motorhome Discount Plan: Motorhomes will receive the passenger vehicle rate based on the number of axles on the motorhome. (Proof of Motorhome registration is required.)