Get My Authority Application

NEW AUTHORITY APPLICATION

You are on the fast track to getting your Authority!

COMPANY INFORMATION
Company Name
DBA (If any)
Company Type

Sole ProprietorshipPartnershipLLCCorporation
EIN (If none, skip)
Contact Name

First NameLast Name
Title
Company Phone
Company Email
example@example.com
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Different Mailing Address?
Company Mailing Address

Street Address

Street Address Line 2

CityState

Zip
PRINCIPAL(S) OF COMPANY
Same As Company Contact
Full Name

First NameLast Name
Title
% Ownership
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Number
Social Security
Email
example@example.com
Additional Owners

Additional OwnersDifferent Home Mailing Address?
Home Mailing Address

Street Address

Street Address Line 2

CityState

Zip
GVW (Weight of truck and trailer fully loaded)
Choose
Select

Interstate (multiple states)Intrastate (just one state)
DOT Number (if none skip)
Number of Trucks
What type of trucks are you running?

Semi TruckDump TruckPick-up TruckBox TruckOther
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
What type of Authority Do You Need?

CarrierBrokerHauling My Own PropertyMoving CompanyOther
Hazardous Material

YesNo
Cargo Type

General Freight - Transports a wide variety of goods. Will suffice for most products.Other
Select

Fresh ProduceUS Mail - Government contract required.Liquids/Gases - Hazmat required.Chemicals - Hazmat required.Metal: Sheets, coils, rollsIntermodal Containers - SCAC code required.Commodities Dry BulkMotor VehiclesPassengersRefrigerated FoodsDrive/Tow AwayOilfield EquipmentBeveragesLogs, Poles, Beams, LumberLivestockPaper ProductsBuilding MaterialsGrain, Feed, HayUtilitiesMobile HomesCoal/CokeAgricultural / Farm SuppliesMachinery, Large ObjectsMeatConstructionGarbage / RefuseWater WellOther
SERVICES
Which service can we assist you with?

DOT Number at no costGet Your Own AuthorityOther
PLEASE ATTACH YOUR DRIVER'S LICENSE (ALL BUSINESS OWNERS) TO THIS APPLICATION

You can take a pic with your phone.
Cancelof
Before submitting this application

click here

https://calendly.com/alexxanderpurcell/new-trucking-business

to schedule a one-on-one session discussing your next steps to successfully becoming authorized.
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