SHARE-THE-FARE Program Application rev. 1.21.26

GREENWICH COMMISSION ON AGING SHARE-THE-FARE APPLICATION
ABOUT SHARE-THE-FARE

The Share-the-Fare program provides two subsidized transportation options for eligible Greenwich Residents age 62 years and older. Share-the-Fare participants may purchase subsidized Uber cards and/or Greenwich Taxi vouchers; a $30 purchase provides a $50 transportation credit. One program member permitted per household. Eligibility must be approved and renewed annually. Monthly purchase limits will apply. Details are outlined in the Share-the-Fare Program Policy, Terms and Conditions below. This application will be solely utilized to determine eligibility for qualified residents. Application processing details are outlined in the Application Procedures below. If you have questions, or if you need a reasonable accommodation or special assistance to complete this application, please contact the Greenwich Commission on Aging at (203) 862-6710.
Please note: We recommend scrolling ahead to review the documentation requirements in Sections 2, 3 and 4 to ensure that you have the necessary documents available for submission as you complete this application. Utilizing a smart phone, iPad or tablet may make it easier to upload photographs of your documentation.

In an effort to support as many qualified individuals as possible, each eligibility requirement necessitates a unique type of documentation. Should you provide an email below, this form will autosave and email you a link to your partially completed form. If not, you may need to begin anew if you exit the form.
Section 1. Contact Information

Please enter your contact information below. Fields marked with a red asterisk are required.
Name

First NameLast Name
Date of Birth

MonthDayYear
Date Now/Today

MonthDayYear
Date
This is your age based upon the date of birth you entered. Please note that individuals must be 62 or older to participate in Share-the-Fare.
Address
Zip Code
Available to residents of the Town of Greenwich only.
City
This field fills automatically based upon the zip code you select.
State
This field fills automatically based upon the zip code you select.
Preferred Phone Number
Format: (000) 000-0000.
Secondary Phone Number
Format: (000) 000-0000.
Email
example@example.com
Section 2. Proof of Identity and Age

Applicant must select one of the following and upload documentation to verify identity and age.
Please select ONE method of identity and age verification.
Please upload a photo or scan of your identity and age verification documentation here.

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Section 3. Proof of Greenwich Residency

Applicant must select ONE of the below to verify current residency in the Town of Greenwich.
Please indicate ONE method of Residency verification. Documentation must be uploaded below unless otherwise noted below.
You indicated that you will verify your residency by submitting an official mailed document. Please upload a photo or scan of your recent utility bill or bank statement here. The mailing address must be clear and legible as part of the bill. It must match the name and address provided above and be dated within the past six months.

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Section 4. Proof of Eligibility

Applicant must meet ONE of the following eligibility criteria. Documentation requirements are specified for each option.
Please select a minimum of ONE eligibility criterion for which you can provide documentation. If more than one applies, you may check any that apply and upload documentation for each, if desired. Only one is required.
Please upload a photo or scan of your eligibility documentation here. Please note: each eligibility option states the required documentation. If you have any questions, please contact the Greenwich Commission on Aging at (203) 862-6710.

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You indicated that you reside in one of the qualified Greenwich Senior and Disabled Housing Units or Communities. Please enter which one of the following below: Agnes Morley Heights, McKinney Terrace II, Parsonage Cottage, Quarry Knoll I and II, Hill House or The Mews. Please ensure that this entry matches the Residency Verification you provided in Section 3.
You indicated that you are a current Greenwich Department of Human Services client, please enter your case worker's name below. Town of Greenwich staff will verify.
If needed, you may download and/or print the form for Certification of Total Permanent Disability here. Click on the three dots (...) furthest to the right to see options to download or print this file.
Section 5. Share-the-Fare Policy, Terms and Conditions

Please read carefully, confirm and sign below.
Please read the Policy, Terms and Conditions of the Share-the-Fare Program. You may click on the three dots (...) furthest to the right to download or print this file.
Important Information About Our Application Procedures

All information provided will be verified to the extent permitted by law including age, identity, residency, income or enrollment in a government assistance program. All applications will be date-stamped when received, and applicants will be informed of the status of their application and in a timely fashion. All information provided will be kept confidential and will only be used to determine eligibility for the Share-the-Fare Program. Only one member per household can be approved to participate in the program. If you are seeking eligibility due to income, applicants must submit verification of income from all sources (such as a signed copy of their most recently filed US Income Tax Return – Form 1040) OR verification of enrollment in Medicaid, SNAP or Medicare Savings Program. Approved program eligibility is for a one-year period. Registration must be approved annually.
I certify, under penalty of perjury, that the information provided on this application is true and complete to the best of my knowledge. I further understand that any misrepresentation or falsification of information will result in my removal from the program and reimbursement to the Town of Greenwich for the 40% subsidy I received on all purchases made.
Please type your name here to sign.
Should be Empty:

GREENWICH COMMISSION ON AGING SHARE-THE-FARE APPLICATION

ABOUT SHARE-THE-FARE

Section 1. Contact Information

Section 2. Proof of Identity and Age

Section 3. Proof of Greenwich Residency

Section 4. Proof of Eligibility

Section 5. Share-the-Fare Policy, Terms and Conditions

Important Information About Our Application Procedures