Direct Freight Systems Profile

1
OWNER'S NAME
2
COMPANY NAME
3
DOT#
4
EIN#(NO SSN)
5
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
Email
example@example.com
7
Phone Number
Please enter a valid phone number.
8
Do you need any assistance with Tags, Fuel Cards, Factoring, and IFTA?
YESNO
9
PLEASE UPLOAD AUTHORITY(MC)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
10
PLEASE UPLOAD: CERT OF INSURANCE(NO ID CARDS)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
11
PLEASE UPLOAD: FORM W9
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
12
PLEASE UPLOAD: NOTICE OF ASSIGNMENT(FACTORING DOCS)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
13
PLEASE UPLOAD: CAB CARD (REGISTRATION)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
14
Do you use a factoring company?
Yes
No
15
EQUIPMENT
26FT BOX TRUCKS
NON CDL HOT SHOT
CDL HOTSHOT
SEMI TRUCK
16
TRAILER TYPE
NO TRAILER-POWER ONLY
53FT FLATBED
53FT FLATBED-STEPDECK
48FT FLATBED
48FT FLATBED- STEPDECK
53FT DRY VAN
53FT REEFER
CONTAINER
TANKERS
Other
17
Sleeper unit
YES
NO
18
Day Cab
YES
NO
19
Please enter lowest temp setting for REEFER only
20
Please enter DOOR CLEARANCE FOR BOX TRUCKS
21
SUPPLIES
TARPS 4FT
TARPS 6FT
TARPS 8FT
CHAINS
STRAPS
V-BOARDS
BLANKETS
DUNNAGE
ETRACKS
WINCH
5TH WHEEL LOCK
AIR RIDE TRAILER
BINDERS
COIL RACKS
LOAD LOCKS
PAD LOCK
PINTLE HOOK/HITCH
CHASSIS
PALLET JACK
ELECTRIC PALLET JACK
Other
22
PLEASE SELECT ALL THAT APPLIES TO THE DRIVER
TWIC CARD
HAZMAT ENDORSEMENT
TANKERS ENDORSEMENT
PPE
ELD
PAPER LOGS
Other
23
DRIVER NAME
24
Do you want the driver to see the full rate confirmation details or address only?
FULL RATE CON
ADDRESS ONLY
OTHER
25
DRIVER PHONE NUMBER
Please enter a valid phone number.
26
DRIVER EMAIL
example@example.com
27
TRUCK AND TRL #
28
PLEASE UPLOAD: IMAGE OF TRUCK WITH TRUCK AND TRAILER #
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
29
MAX WEIGHT YOU CAN HAUL ON TRAILER?(DO NOT PUT 80,000LBS)
30
PREFERRED HOME TIME?Local, Regional, OTR
31
FACTORING PHONE, EMAIL NAME
32
FACTORING ACCOUNT MANAGER NAME, PHONE, EMAILPlease provide all information
33
INSURANCE CO, PH#, EMAIL:Please provide all information
34
ANY OTHER DETAILS? PLEASE ENTER BELOW
35
LOCATION FOR 1ST LOAD?City and state of where you will be empty
36
DESIRED START DATE
Date
Month
Day
Year
37
*RATE PER RATE CONFIRMATION $185REGIONAL/OTR
YES, I AGREE
N/A
38
*RATE PER RATE CONFIRMATION $75LOCAL
YES, I AGREE
N/A
39
40
*DAILY RATE: $85 (REGIONAL/OTR), $45 (LOCAL)Only if loads are searched and driver refuses loads provided
YES, I AGREE
41
Please sign below as verification that the above information you entered in this application is true and has not been altered in any way.* This field is required.
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42
PLEASE ENTER TODAY'S DATE* This field is required.
Date
Year
Month
Day
Should be Empty: