Follow the steps to complete the Pikepass add-on request form accurately.

1. Press the ‘Get Form’ button to access the Pikepass add-on request form in your preferred document editor.
2. Begin with Section I—Account Information. Fill out your account number and account name as indicated. If you are changing your address, indicate this by checking the address change box and provide your new address, city, state, and ZIP code. Include both your daytime and evening phone numbers for contact purposes.
3. Next, locate the Account Access Code field, which is required to process service requests. If you are uncertain about your access code, consult your service representative.
4. Move on to Section II—Vehicle Information. Each vehicle must have a separate Pikepass. Provide details for each vehicle including the license plate, state, plate number, year, make, model/unit number, and the total axle count. For additional vehicles, make sure to use a separate sheet.
5. In Section III, you will specify your auto replenish and secure payment methods. Indicate whether you authorize your credit/debit card to automatically replenish your account balance, to pay any delinquent balance, and for minimum payments if your balance is negative. Choose the type of card you will use (Visa, MasterCard, American Express, or Discover) and enter the card number, expiration date, and amount paid.
6. Next, include the cardholder's name as it appears on the card and provide your signature, which is required for authorization.
7. Finally, complete Section IV—Signatures. If you are the account holder, print your name and sign. If someone else is signing on your behalf, they must also print their name and sign.
8. After verifying all information is correct, you can save your changes, download, print, or share the form as needed.

Complete your Pikepass add-on request form online today for a seamless experience.