New Authority Application

New Authority Application
Company Information
Company Name
DBA (if any)
Company Type

Sole Proprietorship Partnership LLC Corporation
What Type of LLC?
EIN (If none, skip)
Contact First Name
Contact Last Name
Title
Company Phone Number
Company Email
Company Address
City
State
ZIP
County
Different Mailing Address?
Company Mailing Address
City
State
ZIP
County
Principal(s) of Company
Same As Company Contact
First Name
Last Name
Title
% Ownership
Address
City
State
ZIP
Cell Number *
Email Address
Social Security #
Additional Owners

Additional Owners
First Name
Last Name
Title
% Ownership
Address
City
State
ZIP
Cell Number
Email Address
Social Security #
Different Home Mailing Address?
Home Mailing Address
City
State
ZIP
GVW (Weight of truck and trailer fully loaded)
GVW (Weight of truck and trailer fully loaded)
Interstate (multiple states) Intrastate (just one state)
DOT Number (if none skip)
DOT PIN
Number of Trucks
Fleet Description

List each truck in your fleet, if none skip ahead to Driver Information. Attach another page if needed.
Unit #
Year
Make & Model
VIN
Semi Truck Dump Truck Pick-up Truck Box Truck
Additional Trucks?
Unit #
Year
Make & Model
VIN
Semi Truck Dump Truck Pick-up Truck Box Truck
Additional Trucks?
Unit #
Year
Make & Model
VIN
Semi Truck Dump Truck Pick-up Truck Box Truck
Additional Trucks?
Unit #
Year
Make & Model
VIN
Semi Truck Dump Truck Pick-up Truck Box Truck
Additional Trucks?
Unit #
Year
Make & Model
VIN
Semi Truck Dump Truck Pick-up Truck Box Truck
Additional Trucks?
Driver Information

List the number of drivers for each category
Interstate within 100 mi.
Interstate beyond 100 mi.
Intrastate within 100 mi.
Intrastate beyond 100 mi.
Total # of Drivers
Total # of CDL Drivers
Operations
Select One or More

For Hire Private Property Broker Government Contract
What type of Authority Do You Need?

Carrier Broker Hauling My Own Property Moving Company
Hazardous Materials

Yes No
Cargo Type

General Freight - Transports a wide variety of goods. Will suffice for most products. More - Choose from additional cargo types if you have specialized equipment or have a contract to haul something very specific.
Fresh Produce US Mail - Government contract required. Liquids/Gases - Hazmat required. Chemicals - Hazmat required. Metal: Sheets, coils, rolls Intermodal Containers - SCAC code required. Commodities Dry Bulk Motor Vehicles Passengers Refrigerated Foods Drive/Tow Away Oilfield Equipment Beverages Logs, Poles, Beams, Lumber Livestock Paper Products Building Materials Grain, Feed, Hay Utilities Mobile Homes Coal/Coke Agricultural / Farm Supplies Machinery, Large Objects Meat Construction Garbage / Refuse Water Well
YES! Sign me up for Factoring - receiving same day payments on my loads.
YES! Sign me up for the Free Authority program - I sign up for factoring and Authority Express files my DOT, MC, BOC-3, & UCR for free, all I am responsible for are the government fees. I also agree to be bound by the terms of the Free Authority Program, outlined below.
Free Authority Package (DOT, MC, BOC3, UCR) $0 Free DOT Package (DOT) $0
Free Authority Terms Authorization. (By checking this box you agree to the below terms.)
Free Operating Authority consists of MC, DOT, BOC-3, and UCR filings. Free means no filing fees will be assessed by Authority Express LLC for preparing these filings. You will still be responsible for any government or other fees related to these filings. You agree to engage Integrity Factoring & Consulting, Inc. for the purposes of entering into a factoring agreement and hereby authorize them to file a UCC-1 Financing Statement on all principals granting Integrity Factoring & Consulting, Inc. a security interest in the following collateral: All present and future assets of the Debtor. Should you cancel this authorization without receiving factoring services, you agree to pay Integrity Factoring a termination fee in the amount of $1000.00. You hereby grant Integrity Factoring to verify any or all of the foregoing statements, including but not limited to your credit worthiness and financial responsibility. All services are contingent upon Integrity Factoring's review, verification and final written approval. If you fail to complete the factoring setup within 60 days you agree to pay Authority Express LLC full price for services rendered. If you are not approved for factoring you are not eligible for the Free Authority.
PRICES DO NOT INCLUDE GOVERNMENT FEES
Complete Authority Package (DOT, MC, BOC3, UCR, IFTA, IRP, 2290) $950 (Save 15%) Basic Authority Package (DOT, MC, BOC3, UCR) $535 (Save 15%) Post Authority Package (IFTA, IRP, 2290) $475
The IRS does not allow you to pay your 2290 with a credit card. Please provide a bank account and routing number.
Bank Account
Routing Number
Additional Services

DOT Number $250 MC Number $250 Create Business Entity $190 Obtain EIN Number $85 BOC-3 $50 UCR $85 2290 $85 IFTA License $170 IRP Account Setup $220 Enrolled in Drug Consortium Pool $80 Driver Qualification File $150 TX DOT Number $130 CA Number & Permit $175 OR Weight Distance Permit $85 NM Weight Distance Permit $85 KY KYU Weight Distance Permit $85 NY HUT Weight Distance Permit $85 SCAC Code $85 DOT Update $85
Decal Stickers

Full Decals - Company Name, City & State, DOT & MC $50 / pair DOT Decal Stickers $25 / pair MC Decal Stickers $25 / pair DOT & MC Decal Stickers $35 / pair CA# Decal Stickers $25 / pair TX# Decal Stickers $25 / pair KYU# Decal Stickers $25 / pair
Choose Decal Font

A B C D
Choose Decal Color

Black Dark Blue Red Light Blue White
Special Instructions?
Annual Services - 4 Quarters of IFTA Taxes, IFTA License Renewal, IRP Renewal, UCR Renewal, 2290 Renewal, USDOT Update

1-2 Trucks $75 / month 3-10 Trucks $115 / month 11-20 Trucks $175 / month 21+ Call for Quote
PLEASE ATTACH YOUR DRIVER'S LICENSE (ALL BUSINESS OWNERS) TO THIS APPLICATION *

Browse Files

Cancel of
Credit Card Information
PLEASE ATTACH A PHOTO OF THE DEBIT / CREDIT CARD THAT YOU WISH TO USE FOR PAYMENT *

Browse Files

Cancel of
Name on Card
Card Number
Card Number
Exp. Date *
CVC *
Billing Zip Code *
As soon as you obtain a DOT Number, all of your personal contact information becomes public. Unfortunately, this means that you will get spammed via phone and email. In order to protect you from that, we do not enter your personal information into the FMCSA database for the 21-day protest period.

By submitting you agree to be charged for the above services. The fees listed are for Authority Express LLC services. You will still be responsible for any government fees related to these filings.
Should be Empty:

New Authority Application

Company Information

Principal(s) of Company

Fleet Description

Driver Information

Operations

Credit Card Information