Follow the steps to successfully complete the form online.

1. Click the ‘Get Form’ button to obtain the form and open it in the online editor.
2. Start by selecting the appropriate action requested (New, Change, Cancellation) at the top of the form.
3. Provide your applicant information in the specified fields: enter your name, work address, home address, and optional email address accurately.
4. Input your USDA agency code and the last four digits of your social security number. Include your work telephone number.
5. Indicate the mode(s) of transportation you will use daily for your commute. Check all that apply and follow this with the type of fare media you use.
6. Specify the reduced fare public transportation rate you receive. Additionally, state how you previously commuted to work by checking one option provided.
7. Read through the employee certifications carefully. Ensure to check all applicable statements listed to affirm your understanding and compliance.
8. Affix your signature and date the form at the designated fields for employee certification.
9. If applicable, have your commuter benefit coordinator complete the necessary verification fields located at the bottom of the form.
10. Once all fields have been filled out and verified, you may save changes, download the completed form for your records, print copies, or share it as required.

Complete your forms online for a streamlined and efficient process.