Pre pay for a crossing or Top­Up a Dart
Charge Account
Did you know you can register online at www.gov.uk/dart­charge
* Information that must be provided
1. About you (For Pre­Pay only)
Title
First Name*
Middle Name
Last Name*
House number and street*
Town/ City*
County
Postcode*
Country*
Contact phone number*
Email Address
Mr
Mrs
Ms
Miss
Other
2. Vehicle details for Pre Pay only
Please use this section to tell us about the vehicle you will use to make the crossing
Vehicle
Vehicle Registration Mark
(Number plate)
Make (e.g Ford)
Model (e.g Focus)
Colour
Please select the vehicle class;
Class B: Car, including trailers, motor homes,
vans and buses with 9 seats or less
£2.50
Class C: 2 Axle Goods, including vans
£3.00
Class D: Multi Axle Goods
£6.00
Please confirm that you own the vehicle(s) above or have the permission of the
vehicle owner to register and receive information about their vehicle on their behalf
3. Payment details
Please choose one* of the following:
Pre Pay for a Journey
Please ensure you have provided your vehicle and personal
details above
For one­off pre payments, payments are valid and may be used for crossings for up to 12
months in the future only. You may pay for a maximum of 500 crossings in advance.
The charges will apply to the next crossings made using the vehicle detailed above
Manually Top-Up account
Dart Charge Account Number
3.1 Pay using a payment card
Top up or Pre
Payment Amount £*
Minimum top up amount is £10
Please tick one* of the following:
Visa
MasterCard
Amex
Maestro
Name on Card *
Card Number *
Expiry date *
Valid from
MM/YY
CVV
If you would like us to retain your vehicle and card payment details for future
crossings as part of our Pay­As­You­Go service then please tick this box
By signing the box below I authorise Dart Charge to charge my payment card with the amount
shown in the Payment Amount box above
By signing the box below you are confirming you are the cardholder and that you authorise
Dart Charge to take payment.
Signature *
Date *
DD/MM/YYYY
3.2 Payment by Cheque or Postal Order
Cheques or postal orders should be made payable to Dart Charge
Please enclose Cheque or Postal Order and send to;
Dart Charge, PO Box 842, Leeds, LS1 9QF
Value of Cheque or Postal Order Enclosed £*
4. Declaration
Please read the following declaration very carefully.
By signing this form, I certify that the details given on this form are to the best of my knowledge
true and correct. I understand that filing a false declaration knowingly and wilfully is a criminal
offence for which I may be prosecuted.
By signing this form I understand that I must allow sufficient time including allowing for postal
delays for this payment to be received and processed. If I do not allow adequate time then a
Penalty Charge may be applied.
I confirm that I have read and that I understand the above declaration
Signature *
Date *
DD/MM/YYYY
A full copy of the Dart Charge Terms and Conditions can be found on gov.uk/dart­charge or you
request a copy by phone on 0300 300 0120.
Finally
Please send this form with your Dart Charge payment to:
Dart Charge, PO Box 842, Leeds, LS1 9QF
Ensure that you pay the correct postage when sending your application form to us. Sanef
Operations Ltd may charge you if insufficient postage is paid. Sanef Operations Ltd may do this
by deducting the amount of postage from your account credit.
About Dart Charge
We are the Secretary of State for Transport of Great Minster House, 33 Horseferry Road, London,
SW1P 4DR. The Accounts, Local Residents’ Discount Scheme, Tags and website are operated
on our behalf by Sanef Operations Limited as our agent (company number 8703645, registered
in England and Wales, with registered office at ST John's Offices, Albion Street, Leeds, LS2 8LQ
(VAT number GB174301040).