Southern Connector Toll Road - Pal Pass Application

Palmetto Pass Online Application
for Southern Connector Users

Now it's quick and easy to apply online for a new Palmetto Pass Use this simple form to enter your appropriate information, then click the "Submit" button to send! Your Pal Pass will be issued and mailed out to you within 3 business days!

(Fields shown in RED are required)

Step 1: Enter Your Vehicle Information (for up to 5 vehicles)

#	Make	Model	Year	License Plate#	Issuing State
1
2
3
4
5

Step 2: Enter Your Personal Information

Name:
Company/Organization:
Address 1:
Address 2:
City:
State:
Zip Code:
Daytime Phone:	enter as xxx-xxx-xxxx
Evening/Cell Phone:	enter as xxx-xxx-xxxx
Email Address:
PIN Number:	For added security you must choose a 4-digit PIN (numbers only)

Step 3: Enter Your Payment Information

Credit Card Type:
Card Number:
Expiration Date:
CCID Number:	What's This?
Cardholder Name:	exactly as it appears on card

Step 4: Read the License Agreement
To qualify for a Palmetto Pass you must agree to the terms and conditions of use as specified in our license agreement. Clicking "Submit" means you have read, understand and agree to the terms of use set forth in our license agreement. View the agreement by clicking this link.

Step 5: Submit Your Application!
Click the "submit" button below and your information will be securely forwarded to our account processing department. Your Palmetto Pass will be on its way to the address you specified within 3 business days!

Thank you for using the Southern Connector!