Transitchek Order Form PDF Details

Transitchek is a program that allows employees to pay for public transportation with pre-tax dollars. This can save employees money on their monthly commute costs. The Transitchek order form is used to enroll in the program and select the transportation providers you would like to receive benefits from. In this blog post, we will provide an overview of the Transitchek order form and explain how to complete it.

Below is some information that may be beneficial in case you're looking to learn just how long it will require you to complete transitchek order form and just how many PDF pages it has.

QuestionAnswer
Form NameTransitchek Order Form
Form Length2 pages
Fillable?Yes
Fillable fields106
Avg. time to fill out21 min 46 sec
Other namestransitchek commuter enrollment form, transitchek order form 2018, transit check login, transitchek order form

Form Preview Example

SAVE TIME! ORDER ONLINE AT ORDER.TRANSITCHEK.COM

Are you a new customer?

Yes

No

ORDER FORM

New mailing or email address provided?

Yes

 

 

No

Returning customers, please provide your customer number : _______________

COMPANY INFORMATION: Please fill out completely. Your order cannot be processed unless all information is provided.

*Company Name

Date

 

 

 

*Contact

Name/Title

 

 

 

*Address (We do not deliver to P.O. Boxes or Box Zip Codes)

*Suite/Floor/Room

 

 

 

*City

*State

*Zip

 

 

 

*Phone

*Fax

 

*Email (Important: To receive order and shipping confirmation)

Order Frequency: How frequently do you plan to order:

 

Monthly

Quarterly

Semi-Annually

Annually

SHIPPING ADDRESS IF DIFFERENT:

Check if any information on your account has changed

Name

Company Name

 

 

 

Address (We do not deliver to P.O. Boxes or Box Zip Codes)

Suite/Floor/Room

 

 

 

City

State

Zip

 

 

 

Phone

Fax

 

Email (Important: To receive order and shipping confirmation)

PRODUCT SELECTION CHART

TransitChek Prepaid Visa® Card (Not Returnable/Refundable)

 

Denominations

Quantity

Cost/Item

 

 

Total Cost

 

 

 

 

 

 

 

 

 

 

 

 

$30

 

x

$30

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$35

 

x

$35

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$45

 

x

$45

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$50

 

x

$50

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$55

 

x

$55

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$60

 

x

$60

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$65

 

x

$65

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$70

 

x

$70

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$80

 

x

$80

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$89

 

x

$89

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$100

 

x

$100

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$104

 

x

$104

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$110

 

x

$110

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$112

 

x

$112

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$115

 

x

$115

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$120

 

x

$120

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$125

 

x

$125

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$150

 

x

$150

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$175

 

x

$175

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$200

 

x

$200

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$225

 

x

$225

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$240

 

x

$240

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$245

 

x

$245

=

$

 

 

 

 

 

 

 

 

 

 

 

A

 

 

 

 

 

 

 

 

 

 

 

TransitChek Card Total

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The TransitChek Prepaid Visa Card is issued by The Bancorp Bank pursuant

 

 

*Required ields

to a license from Visa U.S.A. Inc. The Bancorp Bank; Member FDIC.

 

 

 

 

 

 

 

TransitChek® Voucher (Not Returnable/Refundable)

Denominations

Quantity

Cost/Item

 

Total Cost

$15

 

x

$15

=

$

 

 

 

 

 

 

$25

 

x

$25

=

$

 

 

 

 

 

 

$30

 

x

$30

=

$

 

 

 

 

 

 

$35

 

x

$35

=

$

 

 

 

 

 

 

$45

 

x

$45

=

$

 

 

 

 

 

 

$50

 

x

$50

=

$

 

 

 

 

 

 

$55

 

x

$55

=

$

 

 

 

 

 

 

$75

 

x

$75

=

$

 

 

 

 

 

 

$100

 

x

$100

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TransitChek Voucher Total

$

B

TransitChek® MetroCard® (New York Metro Region Only)

Pay-Per-Ride Cards (includes 5% bonus)

 

Denominations

 

Quantity

Cost/Item

 

 

Total Cost

 

 

 

 

 

 

 

 

 

 

 

 

$23.81 (10 trips)

 

 

x

$23.81 =

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$35.71 (15 trips)

 

 

x

$35.71 =

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$47.62 (20 trips)

 

 

x

$47.62 =

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$54.76 (23 trips)

 

 

x

$54.76 =

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unlimited Ride Cards

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7–Day Unlimited

 

 

x

$30

=

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7–Day Express

 

 

x

$55

=

$

 

 

 

 

 

Bus Plus

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30–Day Unlimited

 

 

x

$112

=

$

 

 

 

 

 

 

 

 

 

 

 

 

C

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TransitChek MetroCard Total

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D

 

 

 

Total ( A + B + C )

$

 

 

 

 

 

 

 

 

 

 

 

 

 

4.5% Processing Fee ( D X .045)

$

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

Packaging and Delivery

$

18.00

 

F

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Order Cost ( D + E + F )

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

© 2013 WageWorks, Inc. All Rights Reserved.

 

 

 

 

GENOF-0213

Order Instructions

(for your records)

TransitChek is an IRS-approved commuter benefits program that lets employees save money on their commute by transit or eligible vanpools with tax-free dollars. They are eligible to use up to the IRS allowable amount, tax-free. Please visit our website at: www.transitchek.com for more information on using the TransitChek Program and other helpful information.

SAVE TIME! ORDER ONLINE AT ORDER.TRANSITCHEK.COM – MORE PRODUCTS AVAILABLE

ORDER INFORMATION

1.How to Order

Determine how many products you need to order per employee per benefit cycle. There is no minimum order.

2.Payment Options

Orders will not be processed until full payment is received. Please make checks payable to “TransitChek” You may use a Certified Check, Bank Check, Money Order or Bank Transfer when placing your order. Credit card and eCheck/ACH payments are accepted only online at https://order.transitchek.com.

3.Shipments

All products will be received 7-10 business days after receipt of payment. They will arrive in one box, via FedEx 2 Day service, and require a signature for delivery.

4.Fees

Packaging and delivery fees for TransitChek orders are $18. Processing fees are 4.5% of your total order.

For questions about your order or assistance with ordering, call Customer Service at: 1.800.945.CHEK (2435).

Or visit us at www.transitchek.com

SEND FORM & PAYMENT TO:

Standard Deliveries:

 

Overnight & Messenger†† Deliveries:

TransitChek

JPMorgan Chase

General Post Office

Attn: Lockbox 27457

PO Box 27457

4 Chase MetroTech Ctr, 7th Fl. East

New York, NY 10087-7457

Brooklyn, NY 11245

 

 

1.800.945.CHEK (2435)

††Note: Messenger Center is located on Willoughby Street entrance.

PRODUCT RETURN POLICY

TransitChek MetroCard:

TransitChek only allows for unused, unopened TransitChek® Pay-Per-Ride MetroCard® and TransitChek® Unlimited Ride MetroCard® products that are not more than two years past the expiration date to be returned. Damaged MetroCard must be mailed to MTA-NYC Transit for replacement. Pre-addressed postage-paid envelopes with questionnaires (for returns to the MTA-NYC) can be obtained at subway station booths.

Returns should not be sent to the addresses listed above! Please send wrapped MetroCard products to: TransitChek, 1065 Avenue of the Americas, 5th Flr., New York, NY 10018 along with a completed TransitChek Return Authorization Form. For questions about returning wrapped MetroCard products, call TransitChek Customer Service at 1.800.945.CHEK (2435).

TransitChek® Vouchers:

Can not be returned for credit or refund.

TransitChek Prepaid Visa® Card:

Can not be returned for credit or refund. Cards have a one year expiration. Balances on TransitChek Cards that are near expiration or you suspect are damaged can be easily transferred to another TransitChek Card at www.transitchek.com under Manage Your TransitChek.

Please remind your employees to review their current and unused products to make certain they are used before the expiration date.

The TransitChek Prepaid Visa Card is issued by The Bancorp Bank pursuant to a license from Visa U.S.A. Inc. The Bancorp Bank; Member FDIC.

© 2013 WageWorks, Inc. All Rights Reserved.

GENOF-0113

How to Edit Transitchek Order Form Online for Free

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