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Ohio Turnpike Commission PREPAID ACCOUNT APPLICATION

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Ohio Turnpike Commission PREPAID ACCOUNT APPLICATION with the laws ofthe StateofOhio. with thelaws & Conditions shall be governed by and 19. Terms construed Ohio E-ZPass in accordance cation toCustomers. time with notifi any 18. The Commission may modify the E-ZPass and Terms Conditions and Application at beissuedatthesoleoptionof Commission. totheCustomermay check payable or MasterCard, American VISA, Discover crediting Express credit the card. Customer’s A Upon termination, the Commission will refund any positive balance in Customer’s the E-ZPass account account is by terminated, the Customer must return all transponders. to the Customer Service Center at (1-888-876-7453). 1-88-TURNPIKE In the event the either online at www.ohioturnpike.org, by fax to (440) 891-3523, by mail or phone call The 17. Customer may cancel or update their E-ZPass account information at any time le. onfi date ofcards but not limited to credit card information, account address, vehicle status and expiration 16. The Customer agrees to maintain updated information on their Commission. account including including attorney’s fees, incurred by the costs, allCommission pay to agrees Customer the replenishment, upon to declined is card credit tomer’s collect any monies due the 15. Should the balance in the Customer’s E-ZPass account drop below $0 and the Cus- the timeoftoll transaction. 14. Cash payment upon exit will be required if the Customer’s account is suspended at &Conditions. otherTerms b) violationsofany 13. Prepaid accounts may be suspended for: a) credit card of$10.00perstatement. up toamaximumfee replenishment failure; or transponders ve fi each per fee $1.00 a assessed be will them to mailed be to statements online at www.ohioturnpike.org electronically when their free statement is ready. of Customers account can replenishment. access Customers their charge. with a statements valid e-mail le ed address will Customers on be fi notifi 12. requesting Account printed statements transponder. will beassessedoneachunreturned theCommission.A$25.00fee by showing detailed Customer agrees to surrender possession of all transponders immediately upon request transactions will 11. All transponders be shall remain the property of available the Ohio Turnpike Commission. transponder. replacement The upon not be assessed a fee. The standard $0.75 per month service fee will be applied to the that Transponders fail sponder. through no fault of the Customer and are returned will within 30 days from the date of account cancellation to avoid a $25.00 charge per tran- 10. All transponders on a closed account must be returned in good working canusethesametransponder. vehicle condition exit). Under no circumstance will a toll collector 9. E-ZPass transponder hold usage is a limited to transponder one toll so transaction per trip that (one one entry, another instructions. manufacturer’s transponder withthe accordance in vehicles their to transponders mount properly must Customers 8. transponder. 7. Inactive accounts will continue to be charged the monthly service fee (1-888-876-7453). of phoneat1-88-TURNPIKE orby ohioturnpike.org $0.75 per are required to report lost or stolen transponders immediately will be assessed a $25.00 replacement fee plus $3.00 shipping either and handling. Customers online at www. rst four years, the Customer fee. If a is transponder lost, stolen or damaged within the fi service month per $0.75 a assessed be longer no will stolen or lost reported Transponders cation to the Commission that a of transponder has the been day of lost notifi or stolen. 6. The Customer will continue to be responsible for all tolls servicefee. pertransponder incurred assessed amonthly$0.75 through the end sponder ordered from the Commission’s Customer All Service Customers Center. will be 5. Prepaid accounts will be assessed a $3.00 shipping and handling fee for each tran- time. any Commission. The Commission shall have the option to cancel and close the account at the to furnished is data new until suspended immediately be will account Customer’s the card is declined when the Commission attempts to replenish the account. In this case, fee may be assessed if the Customer’s VISA, MasterCard, Discover or American Express account must maintain a balance positive at allE-ZPass times. A A 4. Customer’s $25.00 fails. card optional secondary credit card is recommended and will only be charged if the primary cards. Customers must provide a primary credit card to establish a prepaid account. An 3. The Commission accepts VISA, MasterCard, Discover, and American Express isgreater. whichever credit transponder, per $25.00 to balance account the return to needed amount the b) or days; nated credit card the amount of: a) the monthly average tolls incur E-ZPASS TERMS & CONDITIONS-PREPAID ACCOUNTS CONDITIONS-PREPAID & TERMS E-ZPASS ~ RETAINFORYOURRECORDS OHIO TURNPIKE COMMISSION TURNPIKE OHIO Tear Off and Return this portion to the Ohio Turnpike Commission Fax Application to: Ohio Turnpike Commission (440) 891-3523 OR: PREPAID ACCOUNT APPLICATION Mail Application to: Ohio Turnpike Commission PO Box 460 PLEASE PRINT OR TYPE AND MAIL OR FAX Berea, OH 44017 OR FILL OUT THIS APPLICATION ONLINE AT www.ohioturnpike.org 1-88-TURNPIKE (1-888-876-7453) Please select a 4 Digit Account PIN Number and list it in the boxes supplied to the right. (For access to your account information over the phone and web) Business Name (if applicable) Billing Information Shipping Information (if different from billing information) Mr. Mrs. Ms. Other (circle one) Mr. Mrs. Ms. Other (circle one) Billing Contact Person (First Middle Last) Shipping Contact Person (First Middle Last) CONTACT Title Title INFORMATION Address Address City State Zip Code City State Zip Code Phone # Fax # Phone # Fax # ( ) ( ) ( ) ( ) E-Mail E-Mail Enter two Credit Cards below. P = Primary Card, S = Secondary Card (Secondary card is optional and will only be charged if primary card fails). Credit Card Type and Number: ___ VISA ___ MC ___ AMERICAN EXPRESS ___ DISCOVER Exp. Date MM/YYYY P CREDIT CARDS / Credit Card Type and Number: ___ VISA ___ MC ___ AMERICAN EXPRESS ___ DISCOVER Exp. Date MM/YYYY S / LICENSE PLATE NO. STATE MAKE MODEL YEAR COLOR NOTE: Customers with vehicles other than passenger cars must contact the Customer Service Center at 1-888-876-7453. VEHICLE INFORMATION Total Charged to Credit Number of Passenger Vehicle Transponder(s) requested: Card $ TRANSPONDER ORDER x $25 for beginning balance applied to each transponder ordered A shipping & handling fee of $3.00 per transponder will be deducted from the available beginning balance. INITIAL BALANCE Based on my anticipated toll charge activity, please charge my credit card a higher initial balance of $_______________________ MONTHLY SERVICE FEE A $.75 per transponder service fee will be charged to your E-ZPass account each month. When your prepaid balance drops below $10.00 per transponder, your account will be replenished by charging your designated credit card. FREE detailed replenishment statements are available online at www.ohioturnpike.org (see OTC E-ZPass Terms and Conditions for Prepaid Accounts). Detailed account information is also available 24 hours a day by calling: 1-88-TURNPIKE (1-888-876-7453). REPLENISHMENT STATEMENTS If PRINTED replenishment statements are mailed to you, a $1.00 fee for every 5 transponders issued to the account will be charged to your account, up to a maximum of $10.00 per statement. CHECK HERE IF YOU WISH TO RECEIVE PRINTED REPLENISHMENT STATEMENTS BY MAIL. Date Customer Signature: Signed: My signature and date above confirm that I have read, understand and agree to abide by the Terms and Conditions related to this account. 100909 OHIO TURNPIKE COMMISSION OHIO TURNPIKE COMMISSION Customers with a transponder from any of the E-ZPASS FREQUENTLY ASKED QUESTIONS: E-ZPASS FREQUENTLY ASKED QUESTIONS: agencies listed below will be ready for Ohio’s conversion to E-ZPass. Similarly, Customers who open an Ohio E-ZPass account will be able APPLICATION Q: What is E-ZPass? from the CSC which will be deducted from the initial to utilize their Ohio transponder on any facility A: E-ZPass is a system that allows Customers to pay starting balance. A valid Visa, MasterCard, Discover or accepting the E-ZPass technology. their tolls electronically, without having to stop at American Express credit card is required to open an FOR a booth to pick-up a ticket upon entry to the Ohio E-ZPass account. An initial starting balance of $25.00 E-ZPass Interagency Group members include: Turnpike or stopping to pay a collector upon exit. per transponder will be charged to the Customer’s • Burlington County Bridge Commission (NJ) credit card to establish the E-ZPass account, from • Chicago Skyway PASSENGER Q: How does E-ZPass work? which toll fares and other fees will be deducted. • Delaware Department of Transportation A: The Customer attaches a small transmitter called When the balance on the E-ZPass account is drawn • Delaware River and Bay Authority VEHICLES a transponder to their vehicle windshield. Each tran- down to a cumulative balance of $10.00 per tran- • Delaware River Joint Toll Bridge Commission sponder is encoded with a unique number that is sponder, the Customer’s account will be replenished • Delaware River Port Authority linked to the Customer’s prepaid toll account. When by charging the Customer’s credit card on fi le an • Illinois State Toll Highway Authority the Customer enters or exits the Turnpike, antennas amount equal to the average monthly tolls incurred • Indiana Toll Road installed at the toll plazas pick up the signal from the over the past 90 days or the amount needed to • Maine Turnpike Authority transponder. A computerized system automatically return the account balance to $25.00 per • Maryland Transportation Authority classifi es the vehicle, calculates the proper toll, and transponder, whichever is greater.
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