Privately Owned

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