Authority Application v05.2023

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

Sole ProprietorshipPartnershipLLCCorporation
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
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 Materials

YesNo
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 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
YES! I Want to Participate in the Authority Rebate Program.
Authority Rebate Program applies only to fees charged by Authority Express LLC for preparing the filings. Participant understands that they will still be responsible for any government or other fees related to these filings. To participate in the Authority Rebate Program, 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. 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. Once you factor at least $10,000 in invoices, you will be eligible to have any authority fees charged by Authority Express LLC for preparing filings rebated to you. Maximum rebate for non-CDL class vehicle is $500, maximum rebate for CDL class vehicle is $1,000. All services are contingent upon Integrity Factoring's review, verification and final written approval. If you are not approved for factoring you are not eligible for the Authority Rebate Program.
I have read the Authority Rebate Program Terms of Service and agree to them
PRICES DO NOT INCLUDE GOVERNMENT FEES
CDL Complete Package (DOT, MC, BOC3, UCR, IFTA, IRP, 2290, DQF, D&A Consortium) $1040Non-CDL Complete Package (DOT, MC, BOC3, UCR, DQF) $470Broker Complete Package (DOT, MC, BOC3, UCR) $320
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

Create Business Entity $190Obtain EIN Number $85DOT Number $75MC Number $75BOC-3 $85UCR $100IFTA License $170IRP Account Setup $2202290 $85Driver Qualification File $150Enrolled in Drug Consortium Pool $50TX DOT Number $130CA Number & Permit $175OR Weight Distance Permit $85NM Weight Distance Permit $85KY KYU Weight Distance Permit $85NY HUT Weight Distance Permit $85SCAC Code $85MVR Report $65 per driverOther
Decal Stickers

Full Decals - Company Name, City & State, DOT & MC $50 / pairDOT Decal Stickers $25 / pairMC Decal Stickers $25 / pairDOT & MC Decal Stickers $35 / pairCA# Decal Stickers $25 / pairTX# Decal Stickers $25 / pairKYU# Decal Stickers $25 / pair
How many pairs?
Choose Decal Font

ABCD
Choose Decal Color

BlackDark BlueRedLight BlueWhite
Special Instructions?
Annual Services - 4 Quarters of IFTA Taxes, IFTA License Renewal, IRP Renewal, UCR Renewal, 2290 Renewal, USDOT Update

1-2 Trucks $75 / month3-10 Trucks $115 / month11-20 Trucks $175 / month21+ Call for Quote
Annual Services - UCR Renewal, Unlimited USDOT Update, Priority Processing

1-2 Trucks $25 / month3-10 Trucks $55 / month11-20 Trucks $95 / month21+ Call for Quote
PLEASE ATTACH YOUR DRIVER'S LICENSE (ALL BUSINESS OWNERS) TO THIS APPLICATION*

Browse Files

Cancelof
Please provide an account for fees. If you wish to use a card, please call in.
Account Name
Bank Account
Routing Number
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

Driver Information

Operations

Please provide an account for fees. If you wish to use a card, please call in.