AFFIDAVIT OF NON-LIABILITY RE: 495 EXPRESS LANES ... 2025

1. Click ‘Get Form’ to open the AFFIDAVIT OF NON-LIABILITY in the editor.
2. Begin by entering the Commonwealth/State and County where you reside at the top of the form.
3. Fill in your name as the Registered Owner in the designated field.
4. Input the Unpaid Toll Invoice Number. Remember, a new affidavit is required for each unpaid toll invoice.
5. If nominating another individual for all trips on the invoice, check the box next to 'All'. Otherwise, list relevant trip numbers in the provided space.
6. Enter the disputed toll amount in dollars only.
7. Select one of the sections below regarding your vehicle's status (Sold, Stolen, Rented/Leased, or Not Driving) and complete it with accurate details.
8. Attach any necessary documents such as sale receipts or police reports as required by your selected section.
9. Finally, ensure to sign in front of a notary public to validate your affidavit.

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