Elderly or Disabled Fare Assistance Application

Instructions:

  1. Fill out Form
  2. Attach Proof of Age or Proof of Disability
  3. Click “Submit”
SECTION I Form
Name
Address
City
State
Zip Code
Phone Number
Date of Birth
Age
Disabled
Section II Attach Proof of Age or Disability
If you qualify based on age (65 or older)…

Attach one of the following types of documentation proving age such as:

  • Copy of driver’s license
  • State ID
  • Military ID
  • Birth Certificate
  • Passport
  • Letter from Social Security verifying birth date
ATTACH PROOF OF AGE

OR

If you qualify based on disability…

Attach one of the following types of documentation proving disability such as:

  • Physician’s Letter of Verification stating client is disabled
  • SSI (Supplemental Security Income) Award Letter stating client is disabled
  • Veteran’s Award Letter stating client is disabled
  • Workman’s Compensation Award Letter stating client is disabled
  • Social Security Award Letter stating client is disabled

Documentation must state the applicant is disabled, as per the definition of disability in the Americans with Disabilities Act. An Income Statement does not qualify.

ATTACH PROOF OF DISABILITY
Section III Submit Form

Additional Information

Please allow two weeks to process form. An ID card will be mailed to you within one month.

If you prefer, applications and documentation may be sent via fax, email or mail.

Fax: 513-695-2980
Email: vicki.perry@co.warren.oh.us
Mail: Warren County Grants Administration
406 Justice Drive
Lebanon, OH 45036

Questions? Call us at 513-695-1259

To schedule a ride, call 1-888-297-0990.

To schedule a ride, please call no less than 48 hours in advance: 1-888-297-0990.
Requests for the first two weeks of the month require a seven-day notice.
All trip requests will be served based on availability.