Get 3005-add-on Request Formrev11092010

The 3005-Add-On Request FormRev11092010 is essential for managing PIKEPASS account information and requesting add-ons or replacements. This guide will provide you with a step-by-step approach to complete the form online.

Follow the steps to successfully complete the 3005-Add-On Request Form

1. Press the ‘Get Form’ button to acquire the form and open it in your editor.
2. In Section I, fill in your PIKEPASS account number, account holder's name, address, city, state, ZIP code, and both daytime and evening phone numbers. Make sure to write clearly.
3. In Section II, provide vehicle information. For each vehicle, include the state of the license plate, plate number, year, make, model/unit number, and the total axle count if applicable. Mark the 'Replace' box if you need a sticker replacement.
4. In Section III, gather signatures. The account holder will need to print their name and sign, and if you are not the account holder, you must also print your name and provide your signature.
5. In Section IV, choose your payment method. Opt for either auto replenishment or a one-time payment, and provide your credit/debit card information. Ensure you include the cardholder's name and signature, along with the card number and expiration date.
6. Finally, review the form for accuracy. Once confirmed, you can save your changes, download the form, print it, or share it as needed.

Complete your 3005-Add-On Request Form online today for efficient management of your PIKEPASS account.