Transcription of TA-W68176 E-ZPass Tag Order Form …
1 TA-W68176 (02/2011) E-ZPass Tag Order form motorhome / passenger vehicle towing CombinationsNew york State thruway AuthorityThis 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 : Using the information below, check the box(es) next to the vehicle combination type for which you are requesting a Tag(s). E-ZPass Account NumberCustomer NameCustomer Signature2-Axle Car, Minivan or SUV with:A passenger car, minivan or SUV that is towing a trailer, camper, boat, Pickup Truck with:A 2-axle 4 or 6 tire pickup truck that is towing a trailer, camper or boat using a standard TRUCK2-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 TRUCK towing a 5th Wheel*RECREATIONAL vehicle (RV) OR motorhome **2-Axle motorhome with:RECREATIONAL vehicle (RV) OR motorhome **3-Axle motorhome with.
2 3-Axle Trailer2-Axle Trailer1-Axle Trailer3-Axle Trailer2-Axle Trailer1-Axle Trailer** 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.)* Special towing Discount Plan: Vehicles towing a 5th Wheel Trailer will receive a discounted Trailer2-Axle Trailer3-Axle Trailer3-Axle Trailer2-Axle Trailer1-Axle Trailer2-Axle Car/Trailer1-Axle Trailer** Motor Home Discount* Special towing DiscountTag CodeTWY CLASSTag Requested (check all that apply)0840800763L4L4L2154664H5H210208204 4L4L3L2155H2114H2703H2154644605H4H3 HProof of motorhome registration is requiredProof of motorhome registration is requir
