SmartBenefits® Employer Enrollment Application

Customer Information:
Business Name: Billing Address (if different from business address)
Address: Address:
City: City:
State: State:
Zip: Zip:
Contact Person: Contact Person:
Contact Title:    
Phone: (xxx-xxx-xxxx) Phone: (xxx-xxx-xxxx)
E-Mail: E-Mail:
Business Type: Private SectorFederal/State/Local GovernmentNon-Profit
Employee Benefit Information (optional)
Approximate Number of Employees:
Benefit Category: Pre-Tax Payroll DeductionEmployer Paid BenefitCombinationOfficial Travel
Have you been working with a SmartBenefits Account Representative?  
Method of Payment (select one):
ACH - WMATA Originated (Recommended) Authorizes WMATA (Metro) to automatically draw the payment for your order each month from your designated bank account. Take advantage of this convenient process and complete your enrollment by returning the authorization form we email to you.

ACH - Customer Originated You manually perform an electronic funds transfer each month from you bank to WMATA's bank. Complete your enrollment by returning the Customer Originated EFT agreement form we email to you.

Open Account - Federal/state/local government accounts only. An account representative will contact you to make payment arrangements.

Credit Card- IMPACT, Business Visa, MasterCard, Discover, American Express. An account representative will contact you to make payment arrangements.


 

Terms and Conditions

In the national capital region, the SmartBenefits® program is administered by the Washington Metropolitan Area Transit Authority (WMATA) and entities authorized by WMATA. WMATA provides SmartBenefits® to employers who wish to provide the transit and parking benefit to their employees for commuting to and from work.

By applying, you agree that your company/agency is responsible for managing the program to comply with Internal Revenue Service regulations. While WMATA is pleased to assist employers with the establishment of their SmartBenefits® program, it is the responsibility of each employer to ensure that their program complies with all IRS requirements. We therefore recommend that each employer discuss their program with their own tax advisor to ensure compliance with IRS requirements.

You'll find the details of the Qualified Transportation Fringe Benefits law in Title 26 of the United States Code Section 132(f).

Note: Value added to SmarTrip® cards through SmartBenefits® or other valid transit benefit programs may only be used by qualified employees who receive the benefit from their employer or a WMATA agent. Use by any other person invalidates the value added to SmarTrip®, is illegal, and subjects the person to arrest and/or prosecution.

 

By submitting, you agree to be bound by the terms and conditions contained in this application. Yes No