Your Name (required) Your Email (required) Telephone (required) Mobile Number Address Line 1 (required) Address Line 2 Town/City (required) County (required) Postcode (required) Date of birth (required) I wish to apply for the toll exemption tickets for vehicle registration Vehicle Registration (required) Requirements Photocopy of your PIP /Entitlement Summary with current years date Copy of Registration Document (V5 Log Book- second-page showing taxation class: Disabled) I can confirm that I understand the exemption may only be used whilst I the disabled person am in the vehicle tick here