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 Proprietorship Partnership LLC Corporation
EIN (If none, skip)
Contact Name

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

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Different Mailing Address?
Company Mailing Address

Street Address

Street Address Line 2

City State

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

First Name Last Name
Title
% Ownership
Address

Street Address

Street Address Line 2

City State / Province

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

Additional Owners Different Home Mailing Address?
Home Mailing Address

Street Address

Street Address Line 2

City State

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 Truck Dump Truck Pick-up Truck Box Truck Other
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?

Carrier Broker Hauling My Own Property Moving Company Other
Hazardous Material

Yes No
Cargo Type

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

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 Other
SERVICES
Which service can we assist you with?

DOT Number at no cost Get Your Own Authority CDL Complete Package (DOT, MC, BOC3, UCR, IFTA, IRP, 2290, DQF, D&A Consortium) Non-CDL Complete Package Broker Complete Package (DOT, MC, BOC3, UCR) IFTA Subscriptions Business Starter Package includes EIN and Compliance Management System
Single Compliance Services

MVR and MVR Monitoring Background Check BOC3 UCR DQF and Digital DQF D&A Consortuim Pre Employment Test Post Accident Test Clearing House
Business Growth Services

Business Credit Trucking Company Website Factoring Insurance Dispatching Visa Fuel Card No Credit Check
PLEASE ATTACH YOUR DRIVER'S LICENSE (ALL BUSINESS OWNERS) TO THIS APPLICATION

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Cancel of
Once your application has been submitted you will recieve an email that will allow you to schedule your appointment setting an appointment ensures you have all your questions answered during a time that best fits your schedule. We will then give you a price quote based on your selections. We offer a NET 30 program upon approval.

We are excited to help you grow your business!
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