Employee Enrollment Form

TransitChek is an IRS-approved commuter benefits program that lets you save money by paying for your commute by transit or eligible vanpools with tax-free dollars. You are eligible to use up to $105/month, tax free. Most employees can save up to $400 or more annually in the TransitChek Program. You can use the interactive calculator at www.transitcenter.com/employees/save.aspx to calculate your estimated savings.

To enroll and begin saving, follow the step-by-step instructions below. Use the TransitChek Transit Operators List to find out which product(s) you should choose.

Return this form to your company’s TransitChek Program administrator by: ______

Step 1: TransitChek Product SELECTION Chart

How do you commute to work? Check all that apply. TransitChek® MetroCard® Commuter Rail Ferry MTA NYCT Subway or Bus MTA Bus Bonus Value Cards (includes 20% bonus) PATH Private Bus Line $20 (+ $4 Bonus) ____ x $20 = $_____ Vanpool Other (please specify) ______$30 (+ $6 Bonus) ____ x $30 = $_____ $35 (+ $7 Bonus) ____ x $35 = $_____ Step 2: $40 (+ $8 Bonus) ____ x $40 = $_____

How much are you currently paying for your monthly commute? Unlimited Ride Cards 7–Day Unlimited ____ x $24 = $_____ $______/month 30–Day Unlimited ____ x $76 = $_____ (TransitChek Prepaid Visa® Card)

Step 3: TransitChek® CardTM a Prepaid Visa® Card Additional value from a personal credit card or bank debit card If you are participating in a pretax payroll deduction program, how can be added to the TransitChek Prepaid Visa® Card to pay for much of your pay would you like to set aside, tax-free, toward commuting costs that exceed the initial amount on your Card. your commute each month (The IRS limit is $105/month). If TransitChek is being provided as a fringe, insert the amount being offered each month. ____ x $24 = $______x $30 = $_____ $______/month ____ x $35 = $______x $45 = $_____ Step 4: ____ x $50 = $______x $60 = $_____ Use the TransitChek Product Selection Chart on the right to ____ x $76 = $_____ choose the product(s) you would like to use for your benefit. Please note that if you choose more than one product or select multiple ____ x $105 = $_____ denominations of a single product, the total value of all selections cannot exceed the IRS limit of $105/month. TransitChek® Voucher Can be used like cash to purchase transit tickets and passes . Step 5: Return completed form ____ x $15 = $_____ Return this completed form to your TransitChek Program administrator. TransitChek products will be distributed to you ____ x $30 = $_____ at work and will be ready to use. ____ x $35 = $______x $50 = $_____ Employee name: ______Date: ______

Total of all products selected $______/month

The TransitChek Prepaid Visa® Card is issued by BankFirst, Sioux Falls, SD; Member FDIC. © 2006 TransitCenter, Inc. All Rights Reserved. TCOF-EF-0906 Transit Operators List TransitChek® is accepted by the following transit operators in NY, NJ, CT and PA:

TransitChek® MetroCard® TransitChek® Vouchers is accepted by the following Transit Services: are accepted by the following Operators: Please note: TransitChek Vouchers will not be accepted by NYC MTA City Transit: Transit subway station booths starting January 1, 2007. • Subway • Local Bus Rail Services: • Express Bus (Pay-per-ride cards only) Amtrak MTA Metro-North Railroad • Staten Island Railway Commuter Rail/Shore Line East MTA Bus MTA Long Island Rail Road NJ Transit PATH MTA Bus (Unlimited Ride cards not accepted on Express Buses) New York, Connecticut and Bus Services: Arrow Lines MSB Express Tours TM TransitChek® Card a Prepaid Visa® Card Carl Bieber Bus1 Norwalk Transit/Westport Service is accepted by the following Operators and anywhere Visa Coastal Link Peter Pan Trailways3 debit cards are accepted for transit purchases: CTTRANSIT Sildan Shuttle Danbury/Housatonic Area Spring Valley Coach DATTCO Sunrise Coach Lines Subway and Rail Services: Excellent Bus Service2 Tappan ZEExpress Greater Bridgeport Transit Authority TCAT Bus Service Amtrak Greenwich Shuttle Trailways MTA Transit Subway Trans-Bridge Lines MTA Staten Island Railway HART Bus Service Valley Transit District Kelley Transportation (Derby/Ansonia/Seymour) MTA Long Island Rail Road NJ TRANSIT Leprechaun Line/Hendrick Hudson Waterbury Northeast Transit MTA Metro-North Railroad PATH Leisure Line Westchester County Bee-Line System Martz Trailways Westport Transit New York, Connecticut and Pennsylvania Bus Services: Milford Bus Service CTTRANSIT (at sales outlets in Hartford, New Haven, Stamford and via CTTRANSIT mail and web) Bus Services: Hampton Jitney (including Rockland, Orange and Dutchess counties) Martz Trailways NJ TRANSIT MTA Bus Blue & Grey Transit MTA Long Island Bus Bonanza Bus Peter Pan Trailways4 MTA NYC Transit Bus Carefree Bus Lines Red &Tan Tours Coach USA Renaissance Transit New Jersey Bus Services: (including Rockland, Orange and Dutchess counties) DeCamp Bus Lines Rockland County Transportation 3 Academy Bus Lines Olympia Trails Greyhound /Hudson Transit Hudson County Executive Express Suburban Trails Tickets and passes must be purchased at the Port Authority Bus Terminal in Manhattan for the following bus services: Leisure Line Tour Trans-Bridge Lines Bonanza Bus NJ Transit Martz Trailways Trans-Hudson Lines Coach USA Red & Tan Tours Community Coach Rockland Coaches DeCamp Bus Lines Suburban Trails Ferry Services: Leisure Line Tour TransitChek Vouchers are accepted by several ferry operators at their sales points and through ticket-by-mail programs: Ferry Services: Davis Park and Watch Hill Ferry NY Fast Ferry Haverstraw Ferry NY Water Taxi Fire Island Ferry NY Water Taxi Hoboken Ferry NY Waterway Haverstraw Ferry NY Waterway NY Fast Ferry SeaStreak Hoboken Ferry SeaStreak Liberty Park Water Taxi Sayville Ferry

1 PA-NYC only 2 For Express bus service only Vanpool Services: 3 Monroe-NY 4 Commuter Service only NJ DOT Van Pool Service Van Pool of NJ, Inc. The TransitChek Prepaid Visa® Card is issued by BankFirst, Sioux Falls, SD; Member FDIC. Royal Coachman VPSI Commuter © 2006 TransitCenter, Inc. All Rights Reserved. TCOF-OL-0906 The Rideshare Company