Consultants On Demand
INQUIRY APPLICATION
Looking to start or already in business?
*
YES
NO
Are you a trucking business?
*
YES
NO
Your Contact Information
*
First Name
Last Name
Address
Email Address
Telephone Number
Check all that apply, if you need any of the following.
Management Services
Business Credit
Marketing Tools & Strategies
Insurance(Business, Health, Life Savings, 401k etc)
Complete Business Sweep (allow us to perform A-Z compliance check to ensure you have everything set in place for your business the correct way)
Staffing and Payroll Services
Registered Agent Service
Trademarks & Patents
Grant Proposals
Business Plan
Tax Account Set up
Web/Logo Design/Revision
Other
In your own words, give a brief description of what you are looking for Consultants On Demand to assist with.
*
Save
Submit
Trucking Application
COMPANY DETAILS
ALREADY UP AND FULLY RUNNING?
*
YES
NO
NUMBER OF TRUCKS
INTRASTATE(WITHIN YOUR STATE)
INTERSTATE(ACROSS STATE LINES)
DOT # (IF NONE PLEASE SKIP)
MC# (IF NONE SKIP)
WHAT TYPE OF TRUCKS ARE YOU RUNNING? CHECK ALL THAT APPLY
SEMI TRUCK
DUMP TRUCK
BOX TRUCK
PICK-UP TRUCK
VAN
Other
GVW (Weight of truck and trailer fully loaded)
Please Select
10,000LBS-26,000LBS(STANDARD BOX)
26,001LB-54,999LBS
55,000LBS+
DRIVER INFORMATION
LIST THE NUMBER OF DRIVERS FOR EACH SECTION
Total # of Drivers
Total # of CDL Drivers
Interstate within 100 mi.
Intrastate within 100 mi.
Interstate beyond 100 mi.
Intrastate beyond 100 mi.
Operations
What type of Authority Do You Need?
Carrier
Broker
Hauling My Own Property
Moving Company
Other
Hazardous Materials
YES
NO
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. Please check all that applies.
more extended
Fresh Produce
Chemicals - Hazmat required.
Commodities Dry Bulk
Refrigerated Foods
Beverages
Paper Products
Utilities
Agricultural / Farm Supplies
Construction
US Mail - Government contract required.
Metal: Sheets, coils, rolls
Motor Vehicles
Drive/Tow Away
Logs, Poles, Beams, Lumber
Building Materials
Mobile Homes
Machinery, Large Objects
Garbage / Refuse
Liquids/Gases - Hazmat required
Intermodal Containers - SCAC code required.
Passengers
Oilfield Equipment
Livestock
Grain, Feed, Hay
Coal/Coke
Meat
Water Well
Other
YES! SIGN ME UP FOR FACTORING - receiving same day payments on my loads.
NO THANKS
YES! SIGN ME UP FOR FUEL PROGRAMS - get fuel advance credit card
NO THANKS
YES! SIGN ME UP FOR LODGING PROGRAMS - get lodging advance for your long hauls
NO THANKS
Please Check All that Applies if you are wanting COD to perform these services for your company:
Registered Agent Service
Process Agent
Management Service
INSURANCE ASSISTANCE
FLEET ASSISTANCE
STAFFING ASSISTANCE
Other
**UPON FILING THE FOLLOWING MAY BE REQUIRED AS WELL DEPENDING ON FMCSA COMLIANCE**
BOC3, UCR, IFTA, IRP, 2290, DQF, D&A Consortium, UCR,TX DOT Number, CA Number & Permit, DQF, OR Weight Distance Permit, NM Weight Distance Permit, KY KYU Weight Distance Permit, NY HUT Weight Distance Permit, & SCAC Code.
Special Instructions?
PLEASE ATTACH YOUR DRIVER'S LICENSE (ALL BUSINESS OWNERS)TO THIS APPLICATION
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
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.
Business Application
COMPANY DETAILS
Company’s Name EXACTLY how it is or will be registered
*
Business Owner's Information
*
First Name
Last Name
Address
Email Address
Telephone Number
Percentage Owned of Company
Other person(s) that own 1% or more of this company?
*
Please Select
Yes, there are other owners
Not Applicable
If so, please list all other owner's
*
First Name
Last Name
Address
Email Address
Telephone Number
Percentage Owned of Company
2nd Owner
3rd owner
4th Owner
Business Email (If you need COD to obtain for business please input COD@GMAIL.COM).
*
example@gmail.com
Business Phone Number (If you need COD to obtain for business please input 123-456-789).
*
Please enter a valid phone number.
Business Address (If you need COD to obtain virtual for business please leave blank).
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have a D-U-N-S Number?
*
Yes
No
Not Sure
Please write your mission statement or company slogan, if you have one:
Brief Description of Business Purpose.
*
Start date (If not already in business please list the projected start date
*
-
Month
-
Day
Year
Date
Do you have employees or plan to hire within the next 12 months?
*
Yes
No
Will (is) this business a LLC, DBA, Non- Profit, or Corporation?
*
LLC
DBA
NON-PROFIT
CORPORATION
SOLE PROPRIETORSHIP
Other
Does your business have an EIN, Articles of Organization, or any other licenses or permits under this business? IF SO, PLEASE ATTACH FILES BELOW
*
YES
NO
PLEASE ATTACH LOGOS, OR ANY OTHER FILES AND NOTES THAT MAY PERTAIN TO THE FORMATION, IDEAS, OR NEEDS OF YOUR BUSINESS.
Browse Files
Drag and drop files here
Choose a file
Upload all that apply
Cancel
of
PLEASE UPLOAD A CLEAR PICTURE OF YOUR ID FRONT AND BACK WITH A DARK BACKGROUND AS WE WILL NEED THIS FOR FILING PURPOSES THROUGH YOUR STATE AND GOVERNMENT AGENCIES.
Browse Files
Drag and drop files here
Choose a file
Upload all that apply
Cancel
of
Use this section to tell us more that you would like to add such as colors, concepts, ideas, visions, etc.
Do you need a website and/or Logo Design/Revision
Yes
No
Website Design & Development Questionnaire
MARKETING SERVICE NEEDED
WEBSITE
LOGO
Other
Please write a short business/personal Bio? If you do not require an about page please write N/A below.
*
Do you or your company have any licenses, memberships, disclaimers, contracts, outside links or affiliations that you'd like to highlight on your website? If so please provide below. If there are links please type the full url below as well.
Have you already registered a domain name? If so, what is it and what company did you use to register and the domain name? If you just need a revision to that site please specify that below.
*
Who is your target audience/customer? (Age, gender, interests)
Website Interview/Expectations
When is your goal launch date for your website?
*
/
Month
/
Day
Year
Date Picker Icon
What services are you interested in?
DOMAIN REGISTRATION
WEBSITE DESIGN & DEVELOPMENT
WEBSITE ENHANCEMENT
E-COMMERCE/SHOPPING CART
GRAMMAR & TEXT EDITING
WEBSITE MAINTENANCE
OTHER (PLEASE DESCRIBE BELOW)
What would you like your domain name to be? If you already have a domain, please state it here. Please list 3 options with number one being the most desired and so on.
If you currently have a website, why are you designing/upgrading? What would you like to see/change/improve?
Do you plan to maintain and update your site yourself? Or COD?
Yes
No
Maybe
If you will NOT be hosting your site with us, what is the URL of the hosting company? (E.g. http://www.godaddy.com)
What is the purpose of your website? Check all that apply:
E-COMMERCE/ONLINE SALES
IMPROVE CUSTOMER SERVICE
PROVIDE INFORMATION ON PRODUCTS & SERVICES
BROADEN YOUR CUSTOMER BASE
SUPPLEMENT YOUR CUSTOMER BASE
KEEP IN CONTACT WITH CURRENT CUSTOMERS
IMPROVE SITE DESIGN & LAYOUT
IMPROVE FUNCTIONALITY & NAVIGATION
OTHER (PLEASE DESCRIBE)
BLOGGING
Please provide us with a quick layout for your site (sitemap.) (This should include all sections and subsections of your web site. An example is laid down below.) Home About Us Products Our team Contact Us Privacy Terms & Conditions, ETC
What are your color preferences? Please mention 3 colors of your choice:
Do you have any reference or competitors website that you would like to submit for review for the design process? Please list the website URL's & specific aspects of the site's that you like:
When people visit your website, what would you want them to do? Please check all that apply.
HIRE YOU TO PERFORM SOME SERVICE
JOIN YOUR COMPANY
COMMUNICATE WITH YOU
SEEK INFORMATION ABOUT YOUR PRODUCTS, SERVICES OR ORGANIZATION
TO BE ENTERTAINED
COMPARISON SHOP OR TO BUY A PRODUCT
REGISTER FOR AN ACCOUNT OR EVENT, IF YES, PLEASE DESCRIBE.
VIEW PRICING, PROMO OR PACKAGES
VIEW A CATALOG
Would you like an intro page before the homepage (landing page)? With or without flash?
Do you have any preferences as far as images for your homepage?
Do you have any additional text/content for the homepage?
Please submit any other information pertaining to your site below including content such as photos, flyers, wording etc.
Upload here:
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Advanced Website Options
Please attach an SRS (Flow Diagram) for your site. If you do not have the flow diagram, please specify your requirements in detail when answering the questions below.
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Please select any of the following additional features you would like: Upload below any files that coincide with the selected such as product with pricing and variables.
ABOUT US
CONTACT INFO
PERSONNEL BIOS
TESTIMONIALS
FAQ'S
SERVICE/PRODUCT DESCRIPTIONS
EVENT CALENDAR
CLASSIFIEDS
GUESTBOOK
CHAT ROOM
OPINION POLL
SHOPPING CART
LINKS
PHOTO GALLERY
EMAIL CAPTURE AND ADMIN
CONTENT MANAGEMENT
MAILING LIST (ANNOUNCEMENT ONLY) THIS IS WHAT YOU USE TO SEND OUT ANNOUNCEMENT OR EMAIL NEWS LETTERS.
MAILING LIST DISCUSSION GROUP
ONLINE MESSAGE BOARD ON FORUM
CONTACT, SUBSCRIPTION, SURVEY OR FEEDBACK FORMS
PASSWORD PROTECTION FOR CERTAIN PAGES
SITE SEARCH ENGINE
E-CARDS
MUSIC CLIPS LISTEN/DOWNLOAD/UPLOAD
VIDEO CLIPS VIEW/DOWNLOAD/UPLOAD
FILE UPLOAD (TYPE OF FILE)
WEATHER WIDGET
STOCKS WIDGET
NEWS FEED
Upload here
Upload a File
Drag and drop files here
Choose a file
Cancel
of
How will you be accepting payment through your website? Please check all that apply.
TRADITIONAL PROCESSING (CHECKS, MONEY ORDER, ETC)
REAL-TIME CREDIT CARD PROCESSING (AUTOMATICALLY PROCESSED ON CHECKOUT)
PAYMENT UPON TIME OF SERVICE
DEPOSIT ONLY
Will there be a shipping option on your site? If yes, please select from the following:
UPS
USPS
FEDEX
OTHERS (PLEASE DESCRIBE)
Please provide all social links attached to your business or product below.
Example: https://www.facebook.com/myusername
Are there any additional features you wish to add which have not been mentioned above? Please mention here:
For product sales you will need to provide all variables such as colors, sizes, prices etc. If you don't have this available right now it can be added later.
Upload products here
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Back
Next
Save
Consultants On Demand
Looking to start or already in business?
*
YES
NO
ARE YOU A TRUCKING BUSINESS?
*
YES
NO
Trucking Application
COMPANY DETAILS
Total # of Drivers
Interstate beyond 100 mi.
Intrastate beyond 100 mi.
Operations
Hazardous Materials
YES
NO
more extended
Fresh Produce
Chemicals - Hazmat required.
Commodities Dry Bulk
Refrigerated Foods
Beverages
Paper Products
Utilities
Agricultural / Farm Supplies
Construction
US Mail - Government contract required.
Metal: Sheets, coils, rolls
Motor Vehicles
Drive/Tow Away
Logs, Poles, Beams, Lumber
Building Materials
Mobile Homes
Machinery, Large Objects
Garbage / Refuse
Liquids/Gases - Hazmat required
Intermodal Containers - SCAC code required.
Passengers
Oilfield Equipment
Livestock
Grain, Feed, Hay
Coal/Coke
Meat
Water Well
Other
YES! SIGN ME UP FOR FACTORING - receiving same day payments on my loads.
NO THANKS
YES! SIGN ME UP FOR FUEL PROGRAMS - get fuel advance credit card
NO THANKS
YES! SIGN ME UP FOR LODGING PROGRAMS - get lodging advance for your long hauls
NO THANKS
Please Check All that Applies if you are wanting COD to perform these services for your company:
Registered Agent Service
Process Agent
Management Service
INSURANCE ASSISTANCE
FLEET ASSISTANCE
STAFFING ASSISTANCE
Other
**UPON FILING THE FOLLOWING MAY BE REQUIRED AS WELL DEPENDING ON FMCSA COMLIANCE**
BOC3, UCR, IFTA, IRP, 2290, DQF, D&A Consortium, UCR,TX DOT Number, CA Number & Permit, DQF, OR Weight Distance Permit, NM Weight Distance Permit, KY KYU Weight Distance Permit, NY HUT Weight Distance Permit, & SCAC Code.
Special Instructions?
PLEASE ATTACH YOUR DRIVER'S LICENSE (ALL BUSINESS OWNERS)TO THIS APPLICATION
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Check all that apply, if you need any of the following.
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.
Do you have a D-U-N-S Number?
*
Yes
No
Not Sure
Company’s Name EXACTLY how it is or will be registered
*
Business Owner's Information
*
First Name
Last Name
Address
Email Address
Telephone Number
Percentage Owned of Company
Other person(s) that own 1% or more of this company?
*
Please Select
Yes, there are other owners
Not Applicable
If so, please list all other owner's
*
First Name
Last Name
Address
Email Address
Telephone Number
Percentage Owned of Company
2nd Owner
3rd owner
4th Owner
Business Phone Number (If you need COD to obtain for business please input 123-456-789).
*
example@gmail.com
Business Address (If you need COD to obtain virtual for business please leave blank).
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Start date (If already in business please list the projected start date
*
-
Month
-
Day
Year
Date
Do you have employees or plan to hire within the next 12 months?
*
Yes
No
Will this business a LLC, DBA, Non- Profit, or Corporation?
*
LLC
DBA
NON-PROFIT
CORPORATION
SOLE PROPRIETORSHIP
Other
Does your business have an EIN, Articles of Organization, or any other licenses or permits under this business? IF SO, PLEASE ATTACH FILES BELOW
*
YES
NO
PLEASE ATTACH LOGOS, OR ANY OTHER FILES AND NOTES THAT MAY PERTAIN TO THE FORMATION, IDEAS, OR NEEDS OF YOUR BUSINESS.
Browse Files
Drag and drop files here
Choose a file
Upload all that apply
Cancel
of
PLEASE UPLOAD A CLEAR PICTURE OF YOUR ID FRONT AND BACK WITH A DARK BACKGROUND AS WE WILL NEED THIS FOR FILING PURPOSES THROUGH YOUR STATE AND GOVERNMENT AGENCIES.
Browse Files
Drag and drop files here
Choose a file
Upload all that apply
Cancel
of
Use this section to tell us more that you would like to add such as colors, concepts, ideas, visions, etc.
Do you need a website design/revision or logo design?
*
Yes
No
Website Design & Development Questionnaire
Company’s Name EXACTLY how it is to be displayed
*
Site Owner's Information
*
First Name
Last Name
Address
Email Address
Telephone Number
Percentage Owned of Company
Have you already registered a domain name? If so, what is it and what company did you use to register and the domain name? If you just need a revision to that site please specify that below.
*
Who is your target audience/customer? (Age, gender, interests)
Website Interview/Expectations
Upload here:
Upload a File
Drag and drop files here
Choose a file
Cancel
of
When is your goal launch date for your website?
*
/
Month
/
Day
Year
Date Picker Icon
Please submit any other information pertaining to your site below including content such as photos, flyers, wording etc.
What services are you interested in?
DOMAIN REGISTRATION
WEBSITE DESIGN & DEVELOPMENT
WEBSITE ENHANCEMENT
E-COMMERCE/SHOPPING CART
GRAMMAR & TEXT EDITING
WEBSITE MAINTENANCE
OTHER (PLEASE DESCRIBE BELOW)
Upload here
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Please attach an SRS (Flow Diagram) for your site. If you do not have the flow diagram, please specify your requirements in detail when answering the questions below.
Upload a File
Drag and drop files here
Choose a file
Cancel
of
What would you like your domain name to be? If you already have a domain, please state it here. Please list 3 options with number one being the most desired and so on.
Please select any of the following additional features you would like: Upload below any files that coincide with the selected such as product with pricing and variables.
ABOUT US
CONTACT INFO
PERSONNEL BIOS
TESTIMONIALS
FAQ'S
SERVICE/PRODUCT DESCRIPTIONS
EVENT CALENDAR
CLASSIFIEDS
GUESTBOOK
CHAT ROOM
OPINION POLL
SHOPPING CART
LINKS
PHOTO GALLERY
EMAIL CAPTURE AND ADMIN
CONTENT MANAGEMENT
MAILING LIST (ANNOUNCEMENT ONLY) THIS IS WHAT YOU USE TO SEND OUT ANNOUNCEMENT OR EMAIL NEWS LETTERS.
MAILING LIST DISCUSSION GROUP
ONLINE MESSAGE BOARD ON FORUM
CONTACT, SUBSCRIPTION, SURVEY OR FEEDBACK FORMS
PASSWORD PROTECTION FOR CERTAIN PAGES
SITE SEARCH ENGINE
E-CARDS
MUSIC CLIPS LISTEN/DOWNLOAD/UPLOAD
VIDEO CLIPS VIEW/DOWNLOAD/UPLOAD
FILE UPLOAD (TYPE OF FILE)
WEATHER WIDGET
STOCKS WIDGET
NEWS FEED
If you currently have a website, why are you designing/upgrading? What would you like to see/change/improve?
How will you be accepting payment through your website? Please check all that apply.
TRADITIONAL PROCESSING (CHECKS, MONEY ORDER, ETC)
REAL-TIME CREDIT CARD PROCESSING (AUTOMATICALLY PROCESSED ON CHECKOUT)
PAYMENT UPON TIME OF SERVICE
DEPOSIT ONLY
Do you plan to maintain and update your site yourself? Or COD?
Yes
No
Maybe
Will there be a shipping option on your site? If yes, please select from the following:
UPS
USPS
FEDEX
OTHERS (PLEASE DESCRIBE)
If you will NOT be hosting your site with us, what is the URL of the hosting company? (E.g. http://www.godaddy.com)
Please provide all social links attached to your business or product below.
Example: https://www.facebook.com/myusername
What is the purpose of your website? Check all that apply:
E-COMMERCE/ONLINE SALES
IMPROVE CUSTOMER SERVICE
PROVIDE INFORMATION ON PRODUCTS & SERVICES
BROADEN YOUR CUSTOMER BASE
SUPPLEMENT YOUR CUSTOMER BASE
KEEP IN CONTACT WITH CURRENT CUSTOMERS
IMPROVE SITE DESIGN & LAYOUT
IMPROVE FUNCTIONALITY & NAVIGATION
OTHER (PLEASE DESCRIBE)
BLOGGING
Are there any additional features you wish to add which have not been mentioned above? Please mention here:
Please provide us with a quick layout for your site (sitemap.) (This should include all sections and subsections of your web site. An example is laid down below.) Home About Us Products Our team Contact Us Privacy Terms & Conditions, ETC
For product sales you will need to provide all variables such as colors, sizes, prices etc. If you don't have this available right now it can be added later.
What are your color preferences? Please mention 3 colors of your choice:
Upload products here
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Do you have any reference or competitors website that you would like to submit for review for the design process? Please list the website URL's & specific aspects of the site's that you like:
Do you need to set up your business legally?
Yes
No
Website Design & Development Questionnaire
Company’s Name EXACTLY how it is to be displayed
*
Site Owner's Information
*
First Name
Last Name
Address
Email Address
Telephone Number
Percentage Owned of Company
MARKETING SERVICE NEEDED
WEBSITE
LOGO (STARTS AT $75)
Other
Please write your mission statement or company slogan, if you have one:
Does your company have a logo? If so, please attach below:
Upload a File
Drag and drop files here
Choose a file
Cancel
of
How long have you been in business?
What is your business address, telephone number, email address?
This will be displayed on site, also will be the email linked to contact submissions, if applicable
Please write a short business/personal Bio? If you do not require an about page please write N/A below.
*
Do you or your company have any licenses, memberships, disclaimers, contracts, outside links or affiliations that you'd like to highlight on your website? If so please provide below. If there are links please type the full url below as well.
Have you already registered a domain name? If so, what is it and what company did you use to register and the domain name? If you just need a revision to that site please specify that below.
*
Who is your target audience/customer? (Age, gender, interests)
Website Interview/Expectations
When is your goal launch date for your website?
*
/
Month
/
Day
Year
Date Picker Icon
What services are you interested in?
DOMAIN REGISTRATION
WEBSITE DESIGN & DEVELOPMENT
WEBSITE ENHANCEMENT
E-COMMERCE/SHOPPING CART
GRAMMAR & TEXT EDITING
WEBSITE MAINTENANCE
OTHER (PLEASE DESCRIBE BELOW)
What would you like your domain name to be? If you already have a domain, please state it here. Please list 3 options with number one being the most desired and so on.
If you currently have a website, why are you designing/upgrading? What would you like to see/change/improve?
Do you plan to maintain and update your site yourself? Or COD?
Yes
No
Maybe
If you will NOT be hosting your site with us, what is the URL of the hosting company? (E.g. http://www.godaddy.com)
What is the purpose of your website? Check all that apply:
E-COMMERCE/ONLINE SALES
IMPROVE CUSTOMER SERVICE
PROVIDE INFORMATION ON PRODUCTS & SERVICES
BROADEN YOUR CUSTOMER BASE
SUPPLEMENT YOUR CUSTOMER BASE
KEEP IN CONTACT WITH CURRENT CUSTOMERS
IMPROVE SITE DESIGN & LAYOUT
IMPROVE FUNCTIONALITY & NAVIGATION
OTHER (PLEASE DESCRIBE)
BLOGGING
Please provide us with a quick layout for your site (sitemap.) (This should include all sections and subsections of your web site. An example is laid down below.) Home About Us Products Our team Contact Us Privacy Terms & Conditions, ETC
What are your color preferences? Please mention 3 colors of your choice:
Do you have any reference or competitors website that you would like to submit for review for the design process? Please list the website URL's & specific aspects of the site's that you like:
When people visit your website, what would you want them to do? Please check all that apply.
HIRE YOU TO PERFORM SOME SERVICE
JOIN YOUR COMPANY
COMMUNICATE WITH YOU
SEEK INFORMATION ABOUT YOUR PRODUCTS, SERVICES OR ORGANIZATION
TO BE ENTERTAINED
COMPARISON SHOP OR TO BUY A PRODUCT
REGISTER FOR AN ACCOUNT OR EVENT, IF YES, PLEASE DESCRIBE.
VIEW PRICING, PROMO OR PACKAGES
VIEW A CATALOG
Would you like an intro page before the homepage (landing page)? With or without flash?
Do you have any preferences as far as images for your homepage?
Do you have any additional text/content for the homepage?
Please submit any other information pertaining to your site below including content such as photos, flyers, wording etc.
Upload here
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Advanced Website Options
Please attach an SRS (Flow Diagram) for your site. If you do not have the flow diagram, please specify your requirements in detail when answering the questions below.
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Please select any of the following additional features you would like: Upload below any files that coincide with the selected such as product with pricing and variables.
ABOUT US
CONTACT INFO
PERSONNEL BIOS
TESTIMONIALS
FAQ'S
SERVICE/PRODUCT DESCRIPTIONS
EVENT CALENDAR
CLASSIFIEDS
GUESTBOOK
CHAT ROOM
OPINION POLL
SHOPPING CART
LINKS
PHOTO GALLERY
EMAIL CAPTURE AND ADMIN
CONTENT MANAGEMENT
MAILING LIST (ANNOUNCEMENT ONLY) THIS IS WHAT YOU USE TO SEND OUT ANNOUNCEMENT OR EMAIL NEWS LETTERS.
MAILING LIST DISCUSSION GROUP
ONLINE MESSAGE BOARD ON FORUM
CONTACT, SUBSCRIPTION, SURVEY OR FEEDBACK FORMS
PASSWORD PROTECTION FOR CERTAIN PAGES
SITE SEARCH ENGINE
E-CARDS
MUSIC CLIPS LISTEN/DOWNLOAD/UPLOAD
VIDEO CLIPS VIEW/DOWNLOAD/UPLOAD
FILE UPLOAD (TYPE OF FILE)
WEATHER WIDGET
STOCKS WIDGET
NEWS FEED
How will you be accepting payment through your website? Please check all that apply.
TRADITIONAL PROCESSING (CHECKS, MONEY ORDER, ETC)
REAL-TIME CREDIT CARD PROCESSING (AUTOMATICALLY PROCESSED ON CHECKOUT)
PAYMENT UPON TIME OF SERVICE
DEPOSIT ONLY
Will there be a shipping option on your site? If yes, please select from the following:
UPS
USPS
FEDEX
OTHERS (PLEASE DESCRIBE)
Please provide all social links attached to your business or product below.
Example: https://www.facebook.com/myusername
Are there any additional features you wish to add which have not been mentioned above? Please mention here:
For product sales you will need to provide all variables such as colors, sizes, prices etc. If you don't have this available right now it can be added later.
Upload products here
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Do you need to set up your business legally?
Yes
No
Trucking Application
COMPANY DETAILS
NUMBER OF TRUCKS
INTRASTATE(WITHIN YOUR STATE)
INTERSTATE(ACROSS STATE LINES)
DOT # (IF NONE PLEASE SKIP)
MC# (IF NONE SKIP)
WHAT TYPE OF TRUCKS ARE YOU RUNNING? CHECK ALL THAT APPLY
SEMI TRUCK
DUMP TRUCK
BOX TRUCK
PICK-UP TRUCK
VAN
Other
GVW (Weight of truck and trailer fully loaded)
Please Select
10,000LBS-26,000LBS(STANDARD BOX)
26,001LB-54,999LBS
55,000LBS+
DRIVER INFORMATION
LIST THE NUMBER OF DRIVERS FOR EACH SECTION
Total # of Drivers
Total # of CDL Drivers
Interstate within 100 mi.
Save
Submit
Clear Form
Interstate beyond 100 mi.
Intrastate beyond 100 mi.
Operations
What type of Authority Do You Need?
Carrier
Broker
Hauling My Own Property
Moving Company
Other
When people visit your website, what would you want them to do? Please check all that apply.
HIRE YOU TO PERFORM SOME SERVICE
JOIN YOUR COMPANY
COMMUNICATE WITH YOU
SEEK INFORMATION ABOUT YOUR PRODUCTS, SERVICES OR ORGANIZATION
TO BE ENTERTAINED
COMPARISON SHOP OR TO BUY A PRODUCT
REGISTER FOR AN ACCOUNT OR EVENT, IF YES, PLEASE DESCRIBE.
VIEW PRICING, PROMO OR PACKAGES
VIEW A CATALOG
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. Please check all that applies.
more extended
Fresh Produce
Chemicals - Hazmat required.
Commodities Dry Bulk
Refrigerated Foods
Beverages
Paper Products
Utilities
Agricultural / Farm Supplies
Construction
US Mail - Government contract required.
Metal: Sheets, coils, rolls
Motor Vehicles
Drive/Tow Away
Logs, Poles, Beams, Lumber
Building Materials
Mobile Homes
Machinery, Large Objects
Garbage / Refuse
Liquids/Gases - Hazmat required
Intermodal Containers - SCAC code required.
Passengers
Oilfield Equipment
Livestock
Grain, Feed, Hay
Coal/Coke
Meat
Water Well
Other
YES! SIGN ME UP FOR FACTORING - receiving same day payments on my loads.
NO THANKS
YES! SIGN ME UP FOR FUEL PROGRAMS - get fuel advance credit card
NO THANKS
YES! SIGN ME UP FOR LODGING PROGRAMS - get lodging advance for your long hauls
NO THANKS
Please Check All that Applies if you are wanting COD to perform these services for your company:
Registered Agent Service
Process Agent
Management Service
INSURANCE ASSISTANCE
FLEET ASSISTANCE
STAFFING ASSISTANCE
Other
**UPON FILING THE FOLLOWING MAY BE REQUIRED AS WELL DEPENDING ON FMCSA COMLIANCE**
BOC3, UCR, IFTA, IRP, 2290, DQF, D&A Consortium, UCR,TX DOT Number, CA Number & Permit, DQF, OR Weight Distance Permit, NM Weight Distance Permit, KY KYU Weight Distance Permit, NY HUT Weight Distance Permit, & SCAC Code.
Special Instructions?
PLEASE ATTACH YOUR DRIVER'S LICENSE (ALL BUSINESS OWNERS)TO THIS APPLICATION
*
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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.
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