UCR Filing Form

LEGAL BUSINESS NAME:*

DOING BUSINESS AS NAME (if different from Legal Business Name):

PRINCIPAL PLACE OF BUSINESS:

Address*

3. STREET ADDRESS/ROUTE NUMBER

Street Address Line 2

4. CITY5. STATE/PROVINCE

6. ZIP CODECountry

MAILING ADDRESS:*

Same as Principal Address

Mailing Address

3. STREET ADDRESS/ROUTE NUMBER

Street Address Line 2

4. CITY5. STATE/PROVINCE

6. ZIP CODECountry

PRINCIPAL BUSINESS PHONE NUMBER*

Area CodePhone Number

PRINCIPAL CONTACT CELL PHONE NUMBER

Area CodePhone Number

PRINCIPAL BUSINESS FAX NUMBER

Area CodePhone Number

USDOT NUMBER*

MC or MX NUMBER

IRS/TAX ID NUMBER*

E MAIL ADDRESS:*

Confirmation Email Confirm Email Address

Number of Vehicles Crossing State Lines*

2020 UCR Registration Year – Fees

Number of commercial motor vehicles owned or operated by exempt or non-exempt motor carrier, motor private carrier, or freight forwarder Fee per entity for exempt or non-exempt motor carrier, motor private carrier, or freight forwarder

Fee per entity for broker or leasing company $59

Number of Units. UCR Fee
0-2 $46
3-5 $138
6-20 $276
21-100 $963
101-1,000 $4592
1,001 and above $44836

CERTIFICATION STATEMENT (to be completed by authorized official):

(please type or print name)*

I, named above, certify that I am authorizing Advicom Consulting Services LLC dba A Plus Compliance Group to charge my credit card for the UCR fee based on the brackets above and the $103.95 filing fee for their services. I declare that the information entered on this report is, to the best of my knowledge and belief, true, correct, and complete.

Signature

Title (please type or print)

Date:

Date

Please use this payment area for the filing fee portion of your payment. Your UCR fee will be paid using the method you designated above. All our transactios are safe and secure. We do not store any payment information.

If you have any questions, please call us at 888-654-4686.

Thank you, we appreciate your business.

My Products

UCR Filing FeeFee for filing UCR in addition to the fees listed above.

$103.95

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

UCR 2026 Filing