840-RICR-00-00-1. Reduced Fare Bus Pass Program for Seniors and Individuals with Disabilities (version Adoption, 01/12/2016 to 06/19/2018)

1 REDUCED FARE BUS PASS PROGRAM FOR SENIORS AND INDIVIDUALS WITH DISABILITIES Purpose RIPTA’s Reduced Fare Bus Pass Program (the “Program”) enables seniors (aged 65 or over) and individuals with qualifying disabilities (collectively “Eligible Individuals”) to ride the RIPTA system at reduced fare rates, as such rates are set by RIPTA in accordance with its authority to set fares under Rhode Island General Laws § 39-18-4. To qualify for reduced fares, individuals must obtain a Reduced Fare Bus Pass as provided in this Program, which supersedes all prior programs, policies and procedures regarding reduced fares. The Program consists of this document and the attached Exhibits A, B, and C. Program Eligibility Individuals may qualify for the Program as follows: • Qualifying as a Senior. To qualify as a senior, individuals must show proof of age and proof of identity in accordance with the Senior Application attached as Exhibit A to this document. • Qualifying as a Person with a Disability. To qualify as a person with a disability, individuals must show proof of identity, and must demonstrate they are disabled by submitting one of the following: 1. a Medicare card; 2. documentation showing they are currently receiving Social Security Disability Insurance benefits (“SSDI”) or Supplemental Security Income (“SSI”); 3. a Certification of Disability issued by the Rhode Island Office of Rehabilitative Services (“ORS”) showing that they have a disability that would qualify them for SSDI or SSI benefits. (The Certification of Disability is part of the Disability Application, which is attached as Exhibit B.); 4. a letter from the U.S. Department of Veterans Affairs with a disability rating at or above 40%. REDUCED FARE BUS PASS PROGRAM 2 An individual who establishes eligibility as a senior or a person with a qualifying disability will be entitled to either an “All Day Pass” or a “Limited Day Pass.”1 All Day Passes will permit Eligible Individuals to ride a RIPTA bus at any time for a reduced fare. Limited Day Passes will permit Eligible Individuals to ride a RIPTA bus for a reduced fare during non-peak ridership hours. Non-peak hours are as follows: Weekdays: Before 7:00 a.m.; between 9:00 a.m. and 3:00 pm.; and after 6:00 p.m. Weekends & holidays: All day. Requirements of Income Eligibility Whether an Eligible Individual is able to obtain an All Day or Limited Day Pass will depend on that individual’s income. All Day Passes will be available to Eligible Individuals whose income falls below the income means-test established by the Rhode Island Executive Office of Health and Human Services (“EOHHS”). The means test threshold is currently set at 200% of the federal poverty level.2 Limited Day Passes will be available to Eligible Individuals whose income falls above the means test threshold. To qualify for an All Day Pass, an Eligible Individual must complete the Income Eligibility Application attached as Exhibit C to this document. Note that income eligibility may be established only by presenting a current IRS income tax transcript. If an applicant for a reduced fare bus pass is under age 18, the income of the child’s parent or guardian will be considered for determination of reduced fare status. Reduced Fares for Attendants Individuals who accompany and assist Eligible Individuals who are blind or who use a wheelchair will qualify for a reduced fare. Passes issued to blind individuals or individuals who use a wheelchair will indicate that an attendant who accompanies and assists those individuals will be entitled to a reduced fare. Applying For a Reduced Fare Bus Pass There are three ways to obtain applications for Reduced Fare Bus Passes: 1. Web Download: From the RIPTA website – www.ripta.com/buspassprogram. . 2. Request by Phone: Call RIPTA Customer Service at 401-781-9400. 1 However, no fare reduction will apply on special service routes or over-crowed routes, as determined by RIPTA. 2 Note that this threshold is subject to change. In addition, RIPTA reserves the right to waive the income requirements for special programs, or to enter into contracts that may provide bus passes that may deviate from this policy. No contracts or waivers may affect the provisions regarding use of bus passes. 3 3. In Person: At RIPTA ID Office, 1 Kennedy Plaza, Providence RI 02903 (Monday-Thursday, 9 AM to 4 PM); or RIPTA Information Desk, 705 Elmwood Avenue, Providence RI 02907 (Monday-Friday, 9 AM to 4 PM) Applications may be hand-delivered to the RIPTA offices above or mailed to the Elmwood Avenue office. Application Processing RIPTA staff will confirm the information provided in the application(s) and notify applicants within 21 business days of their status. Applicants approved to receive Reduced Fare Bus Passes will be scheduled for an appointment to have their photograph taken and receive their pass. If an applicant has an existing reduced fare bus pass that was issued after January 1, 2014, there shall be no charge for a new pass. If an applicant has an existing pass that was issued before January 1, 2014, there will be a $10.00 administrative charge for the pass, which shall be payable by cash, money order, or by other means as established by RIPTA in the future. Individuals must present valid photo identification (e.g., a drivers license, passport or other acceptable government-issued identification) to obtain a pass. Pass Renewals Passes will be valid for two years. After a pass expires, the holder of the pass must reapply in accordance with the provisions of this Program. However, RIPTA reserves the right to decrease or increase the duration of time for which a pass shall be valid. Replacement Passes Replacement of lost or stolen passes must be requested in person. A damaged bus pass must be returned to RIPTA in order to obtain a replacement. A fee of $20 will be charged for all replacement passes. Applicable Fares Passes issued under this Program are only valid for the purpose of qualifying for a reduced fare. The fare paid by a pass-holder is subject to change based on any fare change instituted by RIPTA. Passes do not entitle the pass-holder to transportation on the RIPTA system. Use of RIPTA Bus Passes All passes issued under this Program must be kept in the possession of the qualifying person at all times while riding RIPTA services. RIPTA bus passes are electronic and must register on the farebox to be accepted. Drivers have the right to verify the photo ID of the user. Improper Use of RIPTA Bus Passes RIPTA reserves the right to confiscate or revoke any bus pass that has been used improperly. Improper use includes: 4 • Using an expired pass • Using someone else’s pass • Defacing a pass • Sharing or selling a pass • Improperly or fraudulently obtaining a pass An individual who improperly uses his/her bus pass may be suspended from the Program for a period of up to one year, after which the individual may reapply. Any further improper use shall result in a permanent revocation of the individual’s pass and expulsion from the Program. Appeals A person may choose to file an appeal if his/her application is denied or his/her pass is confiscated or revoked. Additional information or any extenuating circumstances can be provided as part of the appeal. An appeal must be filed in writing within 20 business days to: RIPTA Customer Service Manager, Bus Pass Program, 705 Elmwood Avenue, Providence RI 02907 The Customer Service Manager will review all relevant materials, investigate the matter, consult with other parties as necessary, and render a decision within 21 business days of receiving the appeal. EXHIBIT A Last Name _____________________________ First Name __________ _________________ MI _____ Street Address _________________________________________________________________________ City ________________________________________ State _____________ Zip Code ______________ Date of Birth ______________ Phone Number ___________________ Last 4 Digits SSN: _________ Proof of Age (required): Please attach a clear photocopy of a valid, current proof of age. One of the following must be provided: o Medicare Card o Driver’s License o Passport o State ID Card o Green Card/Citizenship Papers Proof of Identity (required): Please attach a clear photocopy of a valid, current photo ID. One of the following must be provided: o Driver’s License o Passport o State ID Card Signature: I hereby attest that the information provided with this application is true, and I authorize RIPTA to conduct verifications as necessary. I understand that if any statements made on this application form are false or inaccurate, or if any of the attachments have been falsified, I will lose the privileges granted by the Reduced Fare Bus Pass Program and be subject to criminal prosecution for fraud in accordance with Rhode Island State Law. Signature: __________________________________ Date: _______________ Print Name: _________________________________ APPLICATION FOR SENIORS REDUCED FARE BUS PASS PROGRAM EXHIBIT B Last Name _____________________________ First Name __________ _________________ MI _____ Street Address _________________________________________________________________________ City ________________________________________ State _____________ Zip Code ______________ Date of Birth ______________ Phone Number ___________________ Last 4 Digits SSN: __________ Proof of Disability To qualify as disabled for purposes of RIPTA’s Reduced Fare Bus Pass Program you must submit to RIPTA one of the following: (1) a Medicare care; (2) documentation demonstrating that you are currently receiving Social Security Disability Insurance benefits (“SSDI”) or Supplemental Security Income (“SSI”); (3) documentation in the form of the Certification of Disability attached to this Application, which Certification of Disability must be completed by the Office of Rehabilitation Services (“ORS”) of Rhode Island’s Executive Office of Human Services. (ORS is located at 40 Fountain St., Providence, RI 02903, tel: (401) 421-7005); or (4) a letter from the U.S. Department of Veterans Affairs with a disability rating at or above 740%. Proof of Identity (required): Please attach a clear photocopy of a valid, current photo ID. One of the following must be provided: o Driver’s License o Passport o State ID Card Signature: I hereby attest that the information provided with this application is true, and I authorize RIPTA to conduct verifications as necessary. I understand that if any statements made on this application form are false or inaccurate, or if any of the attachments have been falsified, I will lose the privileges granted by the Reduced Fare Bus Pass Program and be subject to criminal prosecution for fraud in accordance with Rhode Island State Law. Signature: __________________________________ Date: __________________ Print Name: ________________________________ APPLICATION FOR PEOPLE WITH DISABILITIES REDUCED FARE BUS PASS PROGRAM CERTIFICATION OF DISABILITY Date______________________ The Rhode Island Public Transit Authority Attn: Customer Service Manager 705 Elmwood Avenue Providence, RI 02907 RE: Certification of Disability for: _______________________________ Print Name of Individual Date of Birth:________ Last 4 digits of SSN:___________ This letter certifies that, based on my expertise and assessment, the above named individual has a disability that would qualify him/her for Social Security Disability Insurance benefits (“SSDI”) or Supplemental Security Income (“SSI”), as such criteria for disability is defined by the Social Security Administration. The individual has the following disability: _______________________________________ ________________________________. In making this determination of disability, I have reviewed the following materials: ____________________________________________________, which I certify demonstrate that the above named individual is disabled under the criteria for eligibility for SSDI or SSI. I understand that RIPTA may verify this certification. I can be reached at the following phone number __________________________ and email address ___________________. Sincerely, ____________________________________ [PRINT NAME] EXHIBIT C 1 Last Name _____________________________ First Name __________ _________________ MI _____ Street Address _________________________________________________________________________ City ________________________________________ State _____________ Zip Code ______________ Date of Birth ______________ Phone Number ___________________ SSN: ________________ ______ Proof of Low Income Status (required): An applicant’s total income must not exceed 200% of the Federal Poverty Level, based on review of an IRS Tax Account Transcript. See reverse for Federal Poverty Level thresholds and directions for obtaining a tax transcript. Please attach an IRS Tax Account Transcript for the most recent tax year: o IRS Tax Account Transcript Proof of Identity (required): Please attach a clear photocopy of a valid, current photo ID. One of the following must be provided: o Driver’s License o Passport o State ID Card Signature: I hereby attest that the information provided with this application is true, and authorize RIPTA to conduct verifications as necessary. I understand that if any statements made on this application form are false or inaccurate, or if any of the attachments have been falsified, I will lose the privileges granted by the Bus Pass Program and be subject to criminal prosecution for fraud in accordance with Rhode Island State Law. Signature: __________________________________ __________________ Date: _______________ INCOME ELIGIBILITY APPLICATION REDUCED FARE BUS PASS PROGRAM 2 2015 Poverty Guidelines for the 48 Contiguous States and the District of Columbia Persons in Family/Household Poverty Guideline 200% of Poverty Guideline 1 $11,670 23,340 2 15,730 31,460 3 19,790 39,580 4 23,850 47,700 5 27,910 55,820 6 31,970 63,940 7 36,030 72,060 8 40,090 80,180 Obtaining a Free Tax Account Transcript from the IRS The free Tax Account Transcript provides basic info, including marital status, type of return filed, Adjusted Gross Income, and taxable income. Gather Your Information: § Social Security Number § Date of birth § Street address § Zip code Get Your Transcript: § Go to www.irs.gov OR § Call 800-908-9946 OR § Go to an IRS office IRS Office Locations: § 380 Westminster Street, Providence / 401-525-4282 / Monday-Friday 8:30 AM to 4:40 PM § 60 Quaker Lane, Warwick / 401-826-4979 / Monday-Friday 8:30 AM to 4:40 PM