Parking Purchase Info Form

PTS PURCHASE FORM

Please fill out this information the best you can and submit prior to your scheduled PTS appointment.

This information will help us make your appointment with our customer relations representatives as paperless and efficient as possible.

For assistance call UA PTS main campus at (520) 626-7275 or Phoenix Biomedical Campus at (602) 827-2760

Affiliation (required)

Are you a Student?

YES NO

Are you an Employee?

YES NO

Other Affiliation?

Name (required)

First Name:

Last Name:

Middle Initial:

Address (no campus addresses)

Mailing Address:

City:

State:

Zip:

Contact Info - Email/Phone

UA Email:

Contact Phone:

Employee/Student ID:

Purchase Info

Select Campus.

Tucson Main Phoenix Biomedical

Which of the following products do you plan to purchase? (please answer all)
Cat Tran Shuttle Boarding Pass (MOUNTAIN) ?

YES NO
U-Pass (non refundable):
Purchase Parking Permit?

YES NO

Parking Permit Information

Permit Location/Type:

Vehicle one

Vehicle Two (optional)

Terms & Conditions

If you fail to pay on time and The University of Arizona Parking and Transportation Services Department refers your account(s) to a third party for collection, a collection fee of up to 33.3% or the maximum allowable by law, whichever is lower, will be assessed and will be due and owing at the time of the referral to the third party.

Lost or Stolen permits are not replaced free of charge. Last day for prorated refunds last business day of March.
I understand that failure to comply with the requirements stated in The University of Arizona Motor Vehicle Parking and Traffic Regulations may result in the assessment of fees and fines, impoundment or other institutional enforcement and/or disciplinary action. I also affirm that the information supplied on this form is complete and true. I certify that my vehicles meet the emission requirements of Arizona Revised Statue 49-542.

RFID Units: I understand that the radio frequency identification device (RFID) is the property of The University of Arizona Parking and Transportation Services (PTS). Should I discontinue my permit for any reason, I will return the RFID unit to PTS within 30 calendar days. Failure to do so will result in a currently approved non-return RFID fee. I hereby authorize PTS to charge the fee to my Bursar’s Account or payroll deduction at the time the RFID fee is due. If I don’t pay through this method, I will make payment directly to PTS. I understand that failure to pay this fee would result in collection action in accordance with the UA Motor Vehicle Parking and Traffic Regulations. This agreement is in effect until the device is properly returned to PTS.

Enter initials to agree to these Parking Permit Terms and Conditions:

Method of Payment

This is your intended method of payment, payment will be collected at the time of your appointment.

Select Method of Payment:

Vehicle one

Vehicle Two (optional)

Terms & Conditions