Close Account Form


Account#:  
Name: 
Address: 
  

In order to process your request to close your account, please complete, sign and return this form along with the tag(s) to the address below or at one of our Walk-In Customer Service Centers:

E-ZPass® New York Service Center
Attn: Close Account Processing
PO BOX 149001
Staten Island, New York 10314

Please remember, as per the Terms and Conditions you agreed to upon opening your E-ZPass® account, failure to return the tag(s) will result in your account being charged any applicable lost tag fee(s).

Reason for Closing Account (please check one):

☐ Moving out of area ☐ Changing jobs ☐ Business closing/sold
☐ No longer driving ☐ Other:                                        



I request that you close E-ZPass® account number listed above. I have included all tag(s) which are in my possession.




     
Customer SignatureDate