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The Access-A-Ride NYC application form serves as a critical component for individuals seeking to enroll in the Commuter Benefits Program, specifically designed for those eligible for the MTA New York City Transit Access-A-Ride program or other paratransit services. This form requires applicants to provide essential personal information, including their employee reference number, name, address, email, and telephone number. Additionally, it necessitates the submission of documentation that proves eligibility, such as an Access-A-Ride acceptance letter or photo ID. Applicants have several options available to them within the form, including enrolling in the program, changing personal information, adjusting the monthly deduction amount, temporarily suspending deductions, or canceling their participation altogether. The form also outlines important details regarding the deduction authorization, emphasizing that the total monthly deduction should not exceed the average cost of public transportation. Furthermore, it informs participants about administrative fees associated with the program and the protocol for managing their commuter benefits account through WageWorks. Understanding these elements is vital for a smooth application process and ongoing participation in the Access-A-Ride program.
Similar forms
- Medicaid Application Form: Similar to the Access-A-Ride NYC Application, the Medicaid Application requires proof of eligibility and personal identification information. Both documents aim to provide access to essential services for individuals with specific needs.
- Supplemental Nutrition Assistance Program (SNAP) Application: Like the Access-A-Ride form, the SNAP Application demands documentation to verify eligibility. Both forms focus on assisting individuals in accessing necessary resources to improve their quality of life.
- Social Security Disability Insurance (SSDI) Application: The SSDI Application, similar to the Access-A-Ride form, requires detailed personal information and proof of disability. Both applications serve to help individuals secure benefits that support their daily living.
- Housing Assistance Application: The Housing Assistance Application shares similarities with the Access-A-Ride form in that both require personal identification and eligibility documentation. Each aims to provide essential support to individuals facing challenges in their daily lives.
Form Preview
THE CITY OF NEW YORK COMMUTER BENEFITS PROGRAM
Submit completed form and required documentation to: Your Agency TransitBenefit Coordinator. |
www.NYC.gov/payroll |
www.getwageworks.com/nyc |
IMPORTANT INFORMATION FOR EMPLOYEE
Your enrollment in the Commuter Benefits Program
As proof of eligibility, copies (do not send the originals) of the following must be attached to this enrollment: MTA New York City Transit
Two business days after you enroll in the
EMPLOYEE ACTION
NEW
(Enroll)
CHANGE PERSONAL INFORMATION
(Change Mailing Address, Email or Telephone)
CHANGE DEDUCTION
(Change Amount Deducted from Pay each Month)
SUSPEND DEDUCTION
(Temporarily Stop Deduction from Pay)
CANCELLATION
(Terminate Payroll Deduction)
EMPLOYEE IDENTIFICATION (All fields in this section are required and must be filled out completely. Please Print.)
Employee Reference #* |
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Name (First/Middle/Last) |
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Address Line 1 |
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Address Line 2** |
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City/State/Zip |
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Email Address |
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Telephone |
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* Located on your pay statement or check stub. |
** Apt.#, Fl.# or Box# if applicable. |
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Please enter the total amount, in dollars and cents, you want deducted from your pay each month.
Monthly Deduction Amount
$
SUSPEND
Submit at least 2 weeks before you want to suspend your deduction. Please note this will only suspend your payroll deduction. To also suspend your
MONTH DAY |
YEAR |
MONTH DAY |
YEAR |
PAY DATE TO SUSPEND DEDUCTION |
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PAY DATE TO RESUME DEDUCTION |
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EMPLOYEE CERTIFICATION
I hereby authorize the City of New York to deposit my payroll deduction as indicated above into my WageWorks Commuter Benefits Transit Account.
I also grant authorization for the reversal of a credit to my account in the event the credit was made in error. I understand that, under the “National Automated Clearing House Association” operating guidelines and rules, the City of New York can only reverse the amount of the incorrect direct deposit.
I understand that participation in the
I understand, according to the Internal Revenue Code, that the average monthly amount of my transportation deductions should not exceed my average monthly cost of public transportation to and from work. If my average monthly cost of public transportation to and from work should change, I will change my deduction plan to accommodate my new circumstance. Furthermore, no reimbursement will be provided for
I understand that $3.05 per month, to cover administrative costs of the program, will be paid by the City of New York to WageWorks on my behalf and will be added to my taxable earnings as a fringe benefit each month my account is debited for purchases and/or charges. The administrative charge is
I grant authorization for the City of New York to provide my enrollment information, including mailing address, phone number and
I understand that this authorization will remain in effect until I submit a new request for a change or cancellation.
I understand that my Commuter Benefits Transit Account balance and information will be maintained by WageWorks. Paratransit Service coupons or vouchers must be ordered directly through WageWorks. Transit Account order processing and balance information is accessible online at www.wageworks.com or by calling WageWorks Customer Service at
MONTH DAY YEAR
Employee Signature |
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AGENCY PAYROLL SECTION
Payroll #
Personal information updated in NYCAPS (check all that apply): |
MONTH DAY YEAR |
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Mailing |
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Phone |
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Address |
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NYCAPS ENTRY DATE |
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I certify that the above data was entered in NYCAPS via EForms:
Prepared By (Please Print) |
Signature |
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Date
Common mistakes
Filling out the Access-A-Ride NYC Application form can be straightforward, but mistakes can lead to delays or issues with enrollment. One common error is incomplete personal information. Every field in the employee identification section is mandatory. If any section, such as the employee reference number or contact information, is left blank, the application may be rejected or returned for correction.
Another frequent mistake is failing to provide the required documentation. Applicants must include copies of their MTA New York City Transit Access-A-Ride Acceptance Letter and Access-A-Ride Photo ID or proof of enrollment in a paratransit service program. Not attaching these documents can result in a denial of the application.
Many individuals also miscalculate their monthly deduction amount. The form requires a specific dollar and cents figure. Rounding up or down can lead to discrepancies, which might complicate the payroll deduction process. It’s essential to ensure that the entered amount accurately reflects the intended deduction.
Additionally, some applicants overlook the timing for suspending their deductions. The form specifies that requests to suspend deductions must be submitted at least two weeks in advance. Failing to adhere to this timeline can result in continued deductions, which may not align with the applicant's current needs.
Lastly, a common oversight involves not signing and dating the application. The employee certification section requires a signature to authorize the payroll deduction. If this step is missed, the application cannot be processed. Each of these mistakes can create unnecessary hurdles, so careful attention to detail is crucial when completing the form.
More About Access A Ride Nyc Application
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What is the Access-A-Ride NYC Application form?
The Access-A-Ride NYC Application form is a document that allows eligible individuals to enroll in the Commuter Benefits Program for Access-A-Ride or other paratransit services. This program provides a pre-tax benefit to help cover transportation costs for those who qualify for the MTA New York City Transit Access-A-Ride program or similar services offered by other transit providers.
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What documents do I need to submit with my application?
When submitting your application, you must include copies of certain documents to prove your eligibility. Specifically, you need to attach:
- Your MTA New York City Transit Access-A-Ride Acceptance Letter and Access-A-Ride Photo ID, or
- Proof of Enrollment in a Paratransit Service Program supported by other transit providers.
Remember to send copies, not originals, of these documents.
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How can I manage my payroll deductions for Access-A-Ride?
You have several options for managing your payroll deductions. You can:
- Enroll in the program,
- Change your personal information, such as your mailing address or email,
- Change the amount deducted from your pay each month,
- Suspend your deductions temporarily, or
- Cancel your participation in the program.
To suspend deductions, make sure to submit your request at least two weeks in advance. Keep in mind that suspending your payroll deduction does not automatically suspend your Access-A-Ride service orders; you must handle that separately through WageWorks.
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What happens if I cancel my enrollment in the program?
If you choose to cancel your enrollment, any remaining funds in your Commuter Benefits account will be available for use for 90 days from the cancellation date. After that period, any unspent funds will be forfeited. It's also important to note that a $3.05 monthly administrative fee will be charged to your account, which will be added to your taxable earnings.
Misconceptions
Understanding the Access-A-Ride NYC application form is essential for anyone looking to enroll in this commuter benefits program. However, several misconceptions can lead to confusion. Here are five common misconceptions explained:
- All documents can be submitted in original form. Many applicants believe they can send original documents for proof of eligibility. In fact, only copies should be submitted. This helps to ensure that original documents remain secure.
- Enrollment is automatic once you qualify for Access-A-Ride. Some people think that qualifying for the Access-A-Ride program automatically enrolls them in the commuter benefits program. However, a separate application process is required to enroll in the Access-A-Ride / Paratransit plan.
- You can suspend deductions at any time without notice. It is a common belief that deductions can be suspended immediately. In reality, a request to suspend deductions must be submitted at least two weeks in advance. This allows for proper processing and adjustments.
- All funds in the commuter account are refundable. Many assume that any remaining balance in their commuter benefits account can be refunded at any time. However, funds not used within 90 days after cancellation will be forfeited, making it important to plan accordingly.
- Participation in the program is guaranteed. Some applicants think that once they apply, they will automatically be accepted into the program. However, eligibility is contingent upon meeting specific requirements, and proof of eligibility must be provided to complete the enrollment process.
By understanding these misconceptions, applicants can navigate the Access-A-Ride NYC application process more effectively and ensure they meet all necessary requirements.
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Key takeaways
Filling out the Access-A-Ride NYC Application form requires attention to detail. Here are key takeaways to ensure a smooth application process:
- Eligibility Proof: Attach copies of your MTA New York City Transit Access-A-Ride Acceptance Letter and Photo ID, or proof of enrollment in another paratransit service program.
- Submit to the Right Place: Send your completed form and documentation to your Agency Transit Benefit Coordinator.
- Action Types: Indicate whether you are enrolling, changing personal information, changing deduction amounts, suspending deductions, or canceling your enrollment.
- Deadline for Suspension: Submit your request to suspend deductions at least two weeks before the desired suspension date.
- Monthly Deduction: Clearly specify the amount you wish to have deducted from your pay each month.
- Administrative Fee: Be aware that a $3.05 monthly fee will be charged to cover administrative costs, which will be added to your taxable earnings.
- Account Management: Your Commuter Benefits Transit Account will be managed by WageWorks, and you can access your balance and order processing online.
- Cancellation Policy: If you cancel your enrollment, any remaining funds in your account will be available for 90 days. After that, they will be forfeited.
By following these guidelines, you can navigate the Access-A-Ride application process more effectively and ensure that you meet all requirements.
Access A Ride Nyc Application: Usage Guide
Filling out the Access-A-Ride NYC Application form is an important step to access commuter benefits. Follow these steps carefully to ensure your application is complete and accurate.
- Gather necessary documents. You will need a copy of your MTA New York City Transit Access-A-Ride Acceptance Letter and Access-A-Ride Photo ID or proof of enrollment in another paratransit service program.
- Obtain the Access-A-Ride Application form. You can get it from your Agency Transit Benefit Coordinator or download it from the NYC website.
- Fill out the Employee Identification section. Provide your Employee Reference number, full name, address, email, and telephone number. Make sure to print clearly.
- Decide on your deduction amount. In the DEDUCTION AUTHORIZATION section, enter the total amount you want deducted from your pay each month.
- If you want to suspend your deduction, fill in the dates for suspension and resumption. Remember to submit this request at least two weeks in advance.
- Review the Employee Certification section. Read the statements carefully and ensure you understand them before signing.
- Sign and date the form. Make sure your signature matches the name provided in the identification section.
- Submit the completed form along with your documents to your Agency Transit Benefit Coordinator. Ensure that you do not send original documents.
Once you submit your application, you can expect to receive further instructions. In two business days, visit the WageWorks website or call their customer service to select your coupons or tickets.