Reduced-Fare MetroCard Application

Click here for the Reduced-Fare MetroCard Application in PDF

This application is for existing Reduced-Fare

MetroCard customers

(All payment information will be kept strictly confidential.)

Start paying for your rides with $10.Your account will be automatically replenished whenever the balance goes below $10.Your account immediately converts to unlimited rides when the required number of subway or local bus rides is taken within a 30-day
billing period.

Questions? Call 1-877-323-7433

__________________________________________________________________________________________________________

Last Name

First Name

M.I.

Street Address

Apt. No.

City/Borough

State

Zip Code

- -
Home Telephone

- -
Work/Other Telephone

/ /
Date of Birth

10 digit MetroCard Number

Payment Options (choose one)

Credit Debit Card

American Express

Discover

MasterCard

Visa

Credit/Debit Number

/
Expiration Date

I authorize MTA New York City Transit to charge this credit/debit card for my EasyPay MetroCard refills.

___________________________________________________________________________________________________
Signature	Date

___________________________________________________________________________________________________ Card holder signature (if different)

Applications without Credit/Debit Card authorization signature will be returned to you.

I am a visually impaired customer and wish the following statement:

(check one) Large Type Braille

Mailed completed application to:
Metropolitan Transportation Authority
ATTENTION: EasyPay Program
130 Livingston Street, Brooklyn, New York 11201-9625