Truck Dispatching Carrier Set-Up
Distinct Dispatch LLC provides with Free Set-Up and free advice for consultation on How to Get Started.
MC#/DOT#/INTERSTATE PERMIT
*
EIN
*
COMPANY NAME / DBA /
*
Phone Number #
*
Please enter a valid phone number.
Carrier Name
*
First Name
Last Name
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
INSURANCE COMPANY
*
INSURANCE CONTACT NAME
*
INSURANCE PHONE #
*
Please enter a valid phone number.
NAME OF THE FACTORING COMPANY(ONLY IF YOU USE FACTORING)
Make sure to send NOA for payment
HOW MANY DRIVERS?
*
Please Select
1
2
3
4
5
HOW MANY TRUCKS?
*
Please Select
1
2
3
4
5
Equipment Type
*
What type of trailer do you have? ex: 53' DV, 53' Reefer or 48'/53' Flatbed, 26' Box Truck, Hotshot,etc
What States do you prefer to Drive to? (Please check all that apply)
*
Northeast (NY,NJ,CT,MA,etc.)
Midwest (MT,OH,KY,IN,IL,WI,etc.)
Southeast (FL,GA,LA,AL,etc.)
Southwest (TX,NM,etc.)
West (CA,AZ,OR,NV,ID,etc.)
What areas of the country should we Avoid?
*
Would you like to connect your ELD device for automated tracking?
If so please type in your ELD Provider
How did you hear about Distinct Dispatch LLC?
Other Documents Needed
Please upload copies of your W-9, MC AUTHORITY LETTER and CERTIFICATE OF INSURANCE. Also provide a copy of Driver's license/CDL .
MC Authority Letter
*
Browse Files
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Choose a file
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of
W-9
*
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of
Certificate of Insurance
*
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Choose a file
Cancel
of
Upload Driver's License/CDL
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Any Special Instructions?
Is there anything else you want your dispatcher to know?
Date of Submission / Effective Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: