Toll Dispute Form

For further assistance, please visit the Contact Us page.

This claim report form must be completed in its entirety and submitted within 90 days of the occurrence. Do not send account numbers or credit-card numbers on this form. Your request cannot be processed without all the required information. Contact customer assistance if you require help.

First Name:

Middle Initial:

Last Name:

Driver's License No.:

Email:

Phone:

Address 1:

Address 2:

Country:

City:

State/Province:

Zip/Postal Code:

Check Reason For Reimbursement or Dispute

Lost Ticket / No Ticket Certificate of Passage Short-Change Dispute ($) Weight Class Dispute

ATTENTION: NESHAMINY and WARRENDALE will NOT appear in the dropdown list.
For Neshaminy Falls: For a trip that includes Neshaminy Falls, please select the actual interchange where you entered and/or exited the Turnpike system (i.e. Delaware Valley or Delaware River Bridge).
For Warrendale: For a trip that includes Warrendale, please select the actual interchange where you entered and/or exited the Turnpike system (i.e. New Castle, Beaver Valley, Cranberry or Gateway).

Entry Interchange:

Exit Interchange:

Explanation:

REQUIRED DOCUMENT UPLOAD SECTION – Please read instructions below carefully.

Upload documents by clicking “choose file” below and selecting a file from your computer. Enter a description in the description field and click “Upload File”. All uploaded files will be listed below.
The list of documents to be uploaded, based on the 'Reason for Reimbursement' selected, is as following:

For 'Lost Ticket', upload found ticket and receipt for toll that was paid
For 'No Ticket', upload receipt for toll that was paid
For 'Change Dispute', upload receipt for toll that was paid
For 'Weight class Dispute', upload weight slip, manifest, bill of lading, and receipt for toll that was paid
For 'Certificate of Passage', upload certificate of passage, and toll ticket (if found)

Upload Documents (Max. Size Limit: 10 MB):
Description:

Verification:

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ACTIVE TRAFFIC ADVISORIES (VIEW ALL):

Toll Dispute