Bestpass, Inc. - Order Tag Form

One Transponder - Nationwide Usage

New York State Thruway Tag Order Form

INSTRUCTIONS: Complete Parts 1-3, then Submit

PART 1. CUSTOMER INFORMATION

Company Name:		Thruway Account #:
Company Address:		Representative:
City, State Zip:	,
Email:		Phone:
Ship To: (If Different From Company Address)
Name:
Address:
City, State Zip:	,
Canadian Companies: Please provide overnight courier company and audit number.
Courier:		Audit Number:

PART 2. VEHICLE IDENTIFICATION RECORD/TAG ORDER

You must register a vehicle for every Tag ordered. Also, be sure to provide the Vehicle Reference code based on the number of axils, tires and weight of the entire vehicle combination as it most commonly travels the Thruway. <Click here> for reference location information.

The Vehicle Reference code is not the unit number of the vehicle. Codes are found on Form TA-68162, and describe the type of vehicle, as it most commonly travels the Thruway. (e.g., 727 is the appropriate Vehicle Reference Code for a Tag to be used on a 3 axle tractor that commonly hauls a 2 axle trailer this is up to 40' long.)

Find Your Reference Number
Add & Delete Vehicles
State of Registration	License Plate No.	Year	Make	Vehicle Reference #	Tag Choice

PART 3. CUSTOMER AUTHORIZATION

I agree to all of the terms and conditions of the Commercial Charge Program, including the Credit Agreement (TA-W51312), Post-Paid Terms and Conditions (TA-51312A), Pre-Paid Terms and Conditions (TA-W68167A), Bond Form (TA-W5181) or Cash Surety Deposit Form (TA-W5106), and W-9 if U.S. company or W-8BEN if foreign company. I further represent that I am authorized to execute this Agreement on behalf of the company names in Part 1.

Check here if you agree to the terms listed: