New Jersey Turnpike Authority Senior Citizen Discount Program for E-ZPass®

What You Need to Know…

Thank you for your interest in the E-ZPass Senior Citizen Discount Program. In order to participate in this Program you must be 65 years of age or older, have a New Jersey E-ZPass account, have a valid driver’s license issued by any state, and have a vehicle registered in your name in any state. You do not have to live in New Jersey to open a New Jersey E-ZPass account.

You must have a New Jersey E-ZPass account to participate in the Senior Citizen Discount Program. To verify that your account is with New Jersey E-ZPass, please check your statement. New Jersey E-ZPass statements are issued from Newark, New Jersey.

The Senior Citizen Discount Program is “tag specific” which means that you will be asked to identify the one (1) E-ZPass tag/transponder that will be used exclusively by the eligible senior citizen enrolling in the Program. There is an eleven (11) digit number on the tag/transponder and it must begin with “009” or “022”. What You Need to Do…

To participate in the E-ZPass Senior Citizen Discount Program, you must: 1) have a New Jersey E-ZPass account; 2) have a valid driver’s license issued by any state; 3) have a vehicle registered in your name in any state; and then 4) complete and submit the Application to: New Jersey Turnpike Authority ETC Department P.O. Box 5042 Woodbridge, NJ 07095

Please allow 4-5 weeks for processing. After that time, you may call NJ E-ZPass Customer Service Center at 1-888-288-6865 or check online at www.ezpassnj.com to verify that you are registered for the Program. Click “Check Your Account” then click “Plans”.

Staff at the New Jersey Turnpike Authority is available to answer any questions you may have regarding our Senior Citizen Discount Program. Please feel free to call us at 732-442-8600 ext. 2100.

To register for this Program, you must complete this Application. You must include a copy of your driver’s license and a vehicle registration for the vehicle that is registered in your name. If the proper documentation is not received your application will be returned to you. New Jersey Turnpike Authority Senior Citizen Discount Program for E-ZPass Important Rules: • You must use a designated “E-ZPass Only” lane at all Turnpike and Parkway toll plazas. Do not use a “Cash Only” lane or you will be required to pay the full cash toll. • The eligible senior citizen must be a licensed driver in any state, must have a vehicle registered in his/her name in any state, and must be in the vehicle at the time the transaction occurs. • Discount is valid on off-peak travel only. • The Senior Citizen Discount Program is available to only passenger vehicles. No commercial vehicles can participate in the Program. • Anyone who misuses the E-ZPass Senior Citizen Discount Program will be barred from further participation in the Program. • We reserve the right to assess full cash toll amount retroactively for any and all tolls charged at the Senior Citizen Discount Program rate if any unauthorized use is detected.

For specific information on the terms and conditions of a New Jersey E-ZPass account, please visit www.ezpassnj.com or call 1-888-288-6865 and press “7” to open a new account.

Staff at the New Jersey Turnpike Authority is available to answer any questions you may have regarding our Senior Citizen Discount Program. Please feel free to call us at 732-442-8600 ext 2100.

PLEASE KEEP THIS FORM FOR FUTURE REFERENCE

NJ E-ZPass Account # (13 digits)

E-ZPass Tag/Transponder # (11 digits) NJTA Senior Citizen Discount Program for E-ZPass APPLICATION You Must Have An Active New Jersey E-ZPass Account Before Completing The Following

First Name:______MI:______Last Name:______

Address:______

City:______State:______Zip Code:______Phone Number:

Social Security #: ENTIRE NUMBER NEEDED. New Jersey E-ZPass Account #:

E-ZPass Tag/Transponder #: ONLY ONE TAG / TRANSPONDER PER SENIOR.

Please remember to include a copy of your valid driver’s license and vehicle registration.

ATTENTION: Use of the tag/transponder registered with NJ E-ZPass as eligible for the Senior Citizen Discount Program by anyone who is not eligible and entitled to the Senior Citizen Discount Program will result in loss of privileges to the enrolled senior citizen participant. We reserve the right to assess full cash toll amount retroactively for any and all tolls charged at the Senior Citizen Discount Program rate if any unauthorized use is detected.

To Open a New Jersey E-ZPass Account, you can apply online at www.ezpassnj.com, or call 1-888-288-6865 to apply by telephone or request an application. You can also apply in person at the E-ZPass Customer Service Center located at 375 McCarter Highway in Newark, New Jersey.

Use of Your Social Security Number (SSN) The New Jersey Turnpike Authority is authorized pursuant to N.J.S.A. 27:23-34.1 et seq. to allow for the use of the E-ZPass system on its roadways, and to establish rules and regulations with respect to the use of such system. NJTA is also authorized to establish guidelines for the Senior Citizen Discount Program. In connection with this program, NJTA requests that all applicants provide a valid social security number (“SSN”) at the time of application. The disclosure of your SSN is voluntary, and is not required as a condition of program eligibility. Your SSN will be used for record keeping purposes, to confirm your identity, and to ensure that our database does not contain duplicate entries. To protect against fraud, NJTA may cross-check its records against information provided by the Social Security Administration. If you elect not to provide your SSN, NJTA may require alternative forms of identification for record keeping purposes.

Your privacy is important to us, and NJTA has several measures in place to guard your personal information. Once your SSN is entered in our database, this application form will be shredded and securely discarded. Your SSN will be stored in a secure computer database that is encrypted and available to a limited number of employees.

We will not share your SSN with any third-party, including with any other government agency or organization unless compelled by court order or other legal process.

I have read and understand the above terms and conditions of participation in the NJTA Senior Citizen Discount Program:

______Applicant’s Signature Date Please mail to: New Jersey Turnpike Authority, ETC Department, P.O. Box 5042, Woodbridge, NJ 07095