Professionally Yours - DOT/MC Authority Intake

DOT/MC Authority Intake

*

Business Info

First Name*

Last Name*

Legal Business Owner name

Additional Owners?

YES

NO

List Additional Partners/Owners (1 per line)

Legal Business Name

Business Address

Mailing Address (if Different from listed address)

Phone*

Primary Email*

State of Incorporation

Enter Your EIN # (xx-xxxxxx)

DOT #

Have You Had Your FMCSA Authority Before?

YES

NO

Previous DOT Number/ MC Number

Form of Business

Corporation

Sole Proprietorship

Partnership

Type of Authority Requested

Motor Common Carrier of Property

Motor Contract Carrier of Property

Motor Common Carrier of Household Goods

Motor Contract Carrier of Household Goods

Broker of Property

Broker of Household Goods

Other

Equipment Type

Hot Shot

Semi

Box Truck

Broker

How Many Vehicles Will Be Operated

Number of Straight Trucks and Tractors

Number of Passenger Vehicles

Package Information

Once you click submit, you'll be taken to the payment page where you will select your desired package and can pay in full or use AfterPay to pay in increments. Once payment is recieved, we will begin working on your order. We may call with additional questions, if needed.

Thank you!