Important: All trucks over 3.5 tons must have an active OBU in Belgium. Humanitarian transports for Ukraine have to fill in the form below for possible reimbursement of the transport. This must be done before departure.

Humanitarian goods are understood to mean goods such as blankets, clothing, tents, food parcels, medicines or medical equipment, .... In order to benefit from a toll refund, the cargo must consist exclusively of humanitarian goods. A mixed load of commercial goods/humanitarian goods does not fall under the application of this arrangement.

Fill in the fully completed application form below with the supporting documents or send an email with all the requested information in the form below to contact@viapass.be.
Once approved by Viapass, the kilometer charge will be reimbursed by your service provider.

Contact person (requester/organizer of transport)

First name and surname

E-mail address

Telephone number

Vehicle with which the transport will be carried out

Nationality of the license plate

Brand and type of vehicle

Number plate

Owner or company that owns the vehicle

Please also attach to the completed form a scan (or photo) of the vehicle papers and photos of the front and side view of the vehicle:

Service provider

Select the service provider you used for toll collection in Belgium:
—Please choose an option—AxxèsEurotollSatellicTelepassToll4EuropeTotalEnergies Marketing ServicesWAG Payment SolutionsEurowagnot applicable

Details of the journey

From entry into Belgium

Until departure from Belgium (Valid from 20 June 2022)

Final destination
—Please choose an option—UkrainePolandSlovakiaHungaryRomaniaMoldova

Date of completion

Humanitarian organization or person who commissioned the transport

Name

Address

Country

National recognition number or statutes of the association

Telephone number

E-mail address

Please enclose a copy/proof of the national approval or the statutes of the association with the application form.

Cargo

Nature of the humanitarian goods

Quantity of the goods

With unit: (kg/palettes/crates...)

Is the cargo a combination of humanitarian and commercial goods?
YesNo

Destination

Name

Address

Country

Contact Person: First Name and Surname

Telephone number

E-mail address

This form is to be added to your application for reimbursement that has to be sent to your service provider. However, this does not mean that the request is automatically approved.

1 FORM PER TRANSPORT

This refund scheme comes into force for shipments from 22/06/2022, and will remain in force until further notice.