New Customer Application
Name
*
First Name
Last Name
Company Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
DOT # (if you have)
MC # (if you have)
Social Security Number (Used for IRP / IFTA purposes)
*
Federal ID Number
*
Choose all services your company may be interested in:
*
Authority Information
Corporation Information
Authority Certificate
PrePass
Supervisor Training Course
Drug & Alcohol Consortium / Clearinghouse
DOT Compliance Files
Safety Audit
Biennial Update (MCS-150)
Corrective Action Plan
Sales Tax Exemption
SCAC Code
UIIA
IFTA Stickers
Fuel Tax Reporting
Special State Permits (KYU, NY, NJ, OR, CT, NM)
UCR (Unified Carrier Registration)
Annual Oversize / Overweight Permits
Temp Oversize / Overweight Permits
Hazmat Permits
California CARB
IRP (International Registration Plan)
2290 Heavy Highway Use Tax
Payroll Services
Accounting Services
Personal / Business Taxes
Preparation of 1099's and W-2's
TWIC Cards
Carrier Packets
Corporation Books
Compliance Binders
DBE Program (Disadvantage Business Enterprise)
Upload a copy of the Power of Attorney. Please note, our company can't proceed with any services until we have this on file.
*
Browse Files
Drag and drop files here
Choose a file
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Upload Owner's Driver's License
*
Browse Files
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Upload a copy of your SS-4 form. This is your EIN from the IRS.
*
Browse Files
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Choose a file
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If there are any other services you are needing not shown on this list, please let us know below.
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