Qualified Service Member Hardship Registration Form

The Mobility Authority’s Qualified Service Member Program is limited to one (1) vehicle per qualified service member except in the case of a hardship. A hardship exemption may be granted by the Mobility Authority based on the particular facts and circumstances presented by each applicant. If you believe being limited to one vehicle will result in a hardship specific to you, please include all relevant information supporting your need for a second exemption in the registration form on this page so that your application may be fully evaluated. Hardship allowances will be decided on a case-by-case basis.

Do you have a disabled veteran, Purple Heart, Legion of Valor, Medal of Honor or Disabled Peace Officer license plate? Y/N

Yes

For the Mobility Authority’s Qualified Veteran Discount Program, qualifying Texas license plates are disabled veterans and recipients of the Purple Heart, Legion of Valor and Medal of Honor awards.

Do you have an electronic tag for the vehicle you want to register? Y/N

Yes

Electronic tags are an electronic payment method; you mount the tag sticker on the inside of your windshield behind the rearview mirror and an electronic reader above the toll road sends a signal to the microchip inside the sticker. Then, the tolls are automatically deducted from your tag account, provided there are sufficient funds and your license plate information is up to date.

The Mobility Authority currently accepts TxDOT’s TxTag, NTTA’s TollTag, HCTRA’s EZ TAG, Kansas Turnpike Authority's K-Tag, Oklahoma Turnpike Authority's Pikepass, Fuego Tag , Colorado's E-470 ExpressToll , and BancPass/PlusPass.

To be eligible, the Mobility Authority requires at the time of the transaction the vehicle must not have any outstanding Mobility Authority Tolls. ViaPlus (formerly Cofiroute), our billing provider, bills in 30-day cycles, so you may not have received a bill for outstanding balances. Tolls incurred prior to successful registration in our program must be fully resolved to be eligible for participation in the discount program. Please contact Cofiroute at (833) 762-8655 or visit www.paymobilitybill.com to address any outstanding balances.

Customers wishing to enroll in the Qualified Discount Veterans Program must have an electronic tag associated with the vehicle’s license plate and the tag must be properly displayed in the vehicle. You can click any of these links to be taken to the tag sites to learn more and/or register for a tag: TxTag, TollTag, EZ Tag, K-Tag, Pikepass, BancPass.

Electronic Tag*

Electronic Tag Number*

Service Member Information

First Name*

Last Name*

Phone*

Email Address*

State

Mailing Address*

City*

Zip Code*

Vehicle Information

Year*

Make*

Model*

License Plate Type*

Texas License Plate Number*

Is this vehicle a replacement of a vehicle already enrolled in the Qualified Service Member Program?

Yes

No

Previous Vehicle Information

Thank you for submitting your vehicle update request. Please note the submission of this form does not automatically update the vehicle receiving the discount. An email will be sent to the provided email address once the vehicle update has been completed. If the toll road is used before receiving the confirmation of the update, you may receive charges. These charges will be considered valid.