Navigating the complexity of maintaining an up-to-date account with the Massachusetts E-ZPass system has been streamlined through the Massgovezpassma Change of Information Form. This crucial document caters to E-ZPass MA account holders looking to update their personal details, ensuring their toll transactions are processed smoothly without any hitches. It offers areas to adjust various types of information, including credit/debit card details, checking account numbers, and contact information such as new addresses, phone numbers, and email addresses. Furthermore, the form provides sections for adding authorized users, changing PIN codes, and updating vehicle information, catering to changes in the user’s transportation means. It's important to note that for specific program participants, any vehicle information changes must be supplemented with vehicle registration documents at the E-ZPass Customer Service Center. The form emphasizes the necessity of accuracy and truthfulness, requiring the account holder's signature to validate the changes requested. This comprehensive approach ensures that the account settings remain current with the user’s needs, avoiding potential disruptions in toll payment processes.
| Question | Answer |
|---|---|
| Form Name | Massgovezpassma Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | fastener, Tobin, 4-digit, Ext |
27 Midstate Drive
Auburn, Massachusetts
www.mass.gov/ezpassma
CHANGE OF INFORMATION FORM
I, __________________________________________, would like to change my…
Section A – Credit/Debit Card Information:
To: Credit/Debit Card #: _____________________________________ Exp. Date: ___ - ____
Note: If you previously had Checking Account Information listed on your account, DO NOT use this form. Please submit an Option Change Form.
Section B – Checking Account Information:
To: Routing#: ____________________ |
Account #: ___________________________________ |
Note: If you previously had Credit / Debit Card Information listed on your account, DO NOT use this form. Please submit an Option Change Form.
Section C – NEW Address, Telephone(s) or Email address:
Street Address: ________________________________________________________
City: ___________________________ State: __________ Zip Code: ____________
Home Telephone: (____) ______________ Business Telephone: (____) _____________ Ext_______
Cell Phone: (____) _______________ Fax:(____) ________________________
Email address: _________________________________________________
Section D – User
I would like to add ______________________________ to my
(Print First and Last Name)
Section E – PIN
I would like to change my PIN code to: _____ _____ _____ _____
Section F – Vehicle Information changes (please circle either change or add or delete):
PLEASE NOTE: If you are participating in either the Tunnel Communities or Tobin Resident Program, you must bring a copy of your vehicle registration to the
I would like to change/add/delete my vehicle information to: Do you need extra fastener strips? yes no
NOTE: If you need an additional transponder for any vehicle listed below, please contact the
Plate#_____________State_____Plate Type_____Make ________________Model _______________Year _____
Plate#_____________State_____Plate Type_____Make ________________Model _______________Year _____
I authorize the change of information on my account as indicated above, and certify that all information contained on this form is true and accurate.
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