4. Declaration
I confirm that I have read and accept the terms and conditions
Date*
Signature*
5. What To Do Next
Please send this form, along with your payment, to: Dart Charge, PO Box 842, Leeds, LS1 9QF
Please ensure that you use the correct postage when sending your account top-up by post. If insufficient
postage is paid, emovis Operations Leeds Limited may deduct the difference from your account balance.
About Dart Charge
Highways England are authorised to collect the road user charge on behalf of 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 emovis Operations Leeds
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).
All personal data will be processed in accordance with the GDPR and our privacy policy which can be
found online: www.dartford-crossing-charge.service.gov.uk
DD/MM/YY
By ticking this box, I confirm that the details provided are, to the best of my knowledge, true and correct.
I understand that I must allow 10 working days for this payment to be received and processed and
that I will need to make alternative arrangements to pay for any crossings made before the
payment can be applied to avoid penalty charge notices (PCNs) being issued to the registered
keeper of the vehicle in question.
A full copy of the Dart Charge Terms and Conditions can be obtained at www.gov.uk/dartcharge or
by calling our Contact Centre on 0300 300 0120.