Taxi Voucher Purchase - River Valley Transit

Use this form to reload funding on your taxi voucher account. To qualify, you must must be age 60 or over, have a Medicare card, have a CT statewide Reduced Fare ID card or be certified for ADA paratransit. New Taxi Voucher users must mail in the application form, available online.

Taxi Vouchers(Required)

Taxi vouchers may be purchased in increments of $50. Your cost is half of the voucher amount.

First name

Last Name

Email(Required)

Phone(Required)

Date of Birth (if 60 or over)

Taxi Voucher Qualification(Required)

I am 60 or over

I am certified for ADA Paratransit

I have a Medicare or CT Reduced Fare card

Billing Address(Required)

Total

Payment Method

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code

Refund Policy(Required)

I acknowledge that taxi vouchers are non-refundable.

Comments

This field is for validation purposes and should be left unchanged.

Taxi Voucher Reload Form