COMPLETE – ON TIME – THE FIRST TIME
Carrier Package Federal and State
Package Price: $899 for most but not all states*
Industry Professionals will file and Obtain:
The Federal Required:
Your States Required:
• MC Number
• IFTA
• DOT Number
• IRP
• BOC-3 Processing Agent
• UCR
• Simple Permits (NY, NM, KY)
*Several States have higher filing fees and/or additional requirements. Please call for a specific quote.
Two months complimentary Truckstop.com® Carrier Package (a $210 value)
The industry’s largest load board includes:
Unlimited Truck Posting
Unlimited Lane Posting
Unlimited Freight Searching
Bid Request Searching
Instant Notification
Match My Posted Truck
Access to F.M.C.S.A.
Credit Alerts
CreditStop Broker
CreditStop Broker Watch
List
File Check
FuelDesk Plus
Fuel Stops on Route
Fuel Tax
Industry Alerts
Interactive Online Training
IT Magazine
Load Densities
Mileage Calculation
Missing/Stolen Alerts
Negotiation Strength
Pastwatch
Pintac
ProMiles Routing
Quick Post
Rate Index
Rate Trending
Road Conditions
Truckstop Directory
Weather Conditions
®
Two months complimentary uDrove Prime
This product includes:
Electronic Logs
Vehicle Inspections
Fuel Tax &
Registration Data
Mileage & Load
Tracking
Proof of Delivery
Status
Carrier Package Federal Only
Package Price: $695, all filing fees included
Industry Professionals will file and Obtain:
The Federal Required:
• MC Number
• DOT Number
• BOC-3 Processing Agent
Two months complimentary Truckstop.com® Carrier Package (a $210 value)
Same package of benefits as outlined above
Ask about Cargo and Liability insurance with monthly billing through our partners at
McGriff, Siebels and Williams.
For more information call 866-812-9675, option 2 or e-mail [email protected]
CARRIER AUTHORITY APPLICATION
Applicant Information
Application Date:
Legal Name:
DBA Name
(if applicable)
:
Principal Physical Address
(No PO Box)
:
City:
Mailing Address
(if differen t from Phy sical)
Business Fax Number
Zip:
County:
St:
Zip:
County:
:
City:
Business Phone Number
St:
(Published on FMCSA)
( Published on FMCSA)
Applicant Name:
Title:
Applicant Contact Phone Number
Email:
(ITSFS Use Only)
To be able to set up an account with the FMCSA, there are 3 security questions- (re me mber y our answers so you may log in to the FMCSA in the future .)
1.
Most disliked Vegetable?
2.
Make of 1 st vehicle?
3.
City you were born?
Organization Information
Employer Identification Number (EIN):
*Sole Proprietor who do no t have an EIN may submit their Social Security Number
Type of Business:
Sole Proprietor
Partnership
Corporation
Limited Liability Company (LLC)
Principle/Partner/Officer Full Name:
Title:
Principle/Partner/Officer Full Name:
Title:
Limited Liability Partnership (LLP)
Mexico or Canada Only: Country of Domicile/Principle Place of Business- RFC#:
NSC#:
Affiliations: The FMCSA requires that you disclose any relationship you have had with any other FMCSA regulated entity (including entities licensed by the
FHWA, OMCS, or ICC) within the last three years. Examples include, but are not limited to, a percentage of stock ownership, a loan, or a management position. If
this applies to you, provide the companies MC/FF number and their USDOT number.
MC/FF:
MC/FF:
MC/FF:
DOT:
DOT:
DOT:
Operation Classification & Information
Please contact our office at 866.812.9675 option 2 if you need assistance in answering questions in this section
Operation Classification:
Type of Operation:
Hazardous Materials
Household Goods
Interstate (non-hazardous)
Exempt Commodities
Interstate (hazardous)
Other Non-Hazardous Freight
Intrastate (non-hazardous)
Intrastate (hazardous)
Operating trucks(s) with a gross vehicle weight rating (GVWR) of:
Number of Vehicle with GVWR Greater than 10,000 pounds (most common)
Number of Vehicles with Gross Vehicle Weight rating Greater than 10,000 Pounds: _____ Owned
_____ Leased
Number of Drivers who will operate : _____ Within 100 Air-Mile Radius
_____ Total Drivers
_____ Beyond 100 Air-Mile Radius
Please check all classifications of cargo that applicant transports or handles below:
a.
b.
c.
d.
e.
f.
g.
h.
i.
General Freight
Household Goods
Metal: Sheets, Coils, Rolls
Motor Vehicles
Driveaway / Towaway
Logs, Poles, Beams, Lumber
Building Materials
Mobile Homes achinery, Large Objects
Fresh Produce
ITSFS Use Only- Date filed:
Login:
User#:
j.
k.
l.
m.
n.
o.
p.
q.
r.
s.
Liquids / Gases
Intermodal Containers
Oil Field Equipment
Livestock
Grain, Feed, Hay
Coal / Coke
Meat
Garbage, Refuse, Trash
U.S. Mail
Chemicals
Password:
Login Password:
1
t.
u.
v.
w.
x.
y.
z.
aa.
bb.
Commodities (Dry), in Bulk
Refrigerated Food
Beverages
Paper Products
Utility Service
Farm Supplies
Water Well
Construction
Other (specify): ____________________
CARRIER AUTHORITY REPRESENTATION
Applicant will operate motor vehicles having a gross vehicle weight rating (GVWR) or gross combination weight rating
(GCWR) of 10,001 pounds (4,536 kg) or more to transport:
N on-hazardous commodities ($750,000 U.S.)
Hazardous materials referenced in the FMCSA regulations at 49 CFR 387.303(b)(2)(c) ($1,000,000 U.S.)
Hazardous materials referenced in the FMCSA regulations at 49 CFR 387.303(b)(2)(b) ($5,000,000 U.S.)
Applicants Oath (A-18/N-46):
This oath applies to all Supplemental Filings to this application.
(The signature must be that of an authorized official of the applicant, not the legal representative.)
I, ___________________________, certify that I am familiar with the Federal Motor Carrier Safety Regulations and, if applicable, the Federal
(please type or prin t name)
Hazardous Materials Regulations, and the Federal Motor Carrier Commercial Regulations. Under penalties of perjury, under the laws of the United
States of America, I certify that all information supplied on this form or relating to this application is true and correct. Further, I certify that I am
qualified and authorized to file this application. I know that willful misstatements or omissions of material facts constitute Federal criminal
violations punishable under 18 U.S.C. § 1001 by imprisonment up to 5 years and fines up to $250,000 for each offense. Additionally, these
statements are punishable as perjury under 18 U.S.C. § 1621, which provides for fines up to $250,000 or imprisonment up to 5 years for each
offense.
I further certify under penalty of perjury, under the laws of the United States, that I have not been convicted, after September 1, 1989, of any
Federal or State offense involving the distribution or possession of a controlled substance, or that if I have been so convicted, I am not ineligible
to receive Federal benefits, either by court order or operation of law, pursuant to Section 5301 of the Anti-Drug Abuse Act of 1988, formerly Pub.
L. 100-690, Title V, Section 5301, Nov.18, 1988, 102 Stat. 4310, renumbered and amended Pub. L. 101-647, Title X, Section 1002(d), Nov. 29,
1990, 104 Stat. 4827 (21 U.S.C. § 826).
Signature:
Date:
Title:
Compliance Certifications (M-45)
By signing these certifications, the certifying official is on notice that the representations made herein are subject to verification through the
United States and through the request for examination of records and documents. Failure to support the representations contained in this
application could form the basis of proceeding to assess Civil Penalties and/or lead to the revocation of the authority granted.
1.
2.
Applicant is willing and able to provide the proposed operations or service and to comply with all pertinent statutory
and regulatory requirements and regulations issued or administered by the U.S. Department of Transportation,
including operational regulations, safety fitness requirements, motor vehicle safety standards and minimum
financial responsibility and designation of process agent requirements.
Applicant is willing and able to produce for review or inspection documents which are requested for the
purpose of determining compliance with applicable statutes and regulations administered by the Department of
Transportation, including the Federal Motor Carrier Safety Regulations, Federal Motor Vehicle Safety Standards,
Commercial Regulations, Hazardous Materials Regulations, and Americans With Disabilities Act regulations within
48 hours of any written request. Applicant understands that the written request for documents may be served on
the contact person identified on Page 4 (Section A, Item No. 18), or the designated process agent.
3.
Is applicant presently disqualified from operating commercial motor vehicles in the United States?
4.
Applicant understands that the agent(s) for service of process designated on FMCSA Form BOC-3 will be deemed
applicant’s official representative(s) in the United States for receipt of filings and notices in administrative
proceedings under 49 U.S.C. § 13303, and for receipt of filings and notices issued in connection with the
enforcement of any Federal statutes or regulations.
5.
Applicant is not prohibited from filing this application because its FMCSA registration is currently under
suspension, or was revoked less than 30 days before the filing of this application.
Signature:
Date:
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Title:
All motor carriers operating within the United States, including foreign-domiciled motor carriers applying for USDOT registration by this form, must comply with all applicable
Federal, State, local, and tribal statutory and regulatory requirements when operating within the United States. Such requirements include, but are not limited to, all applicable
statutory and regulatory requirements administered by the U.S. Department of Labor, or by an OSHA State plan agency pursuant to section 18 of the Occupational Safety and Health
Act of 1970. Such requirements also include all applicable statutory and regulatory environmental standards and requirements administered by the U.S. Environmental Protection
Agency or a State, local or tribal environmental protection agency. Compliance with these statutory and regulatory requirements may require motor carriers and/or individual
operators to produce documents for review and inspection for the purpose of determining compliance with such statutes and regulations.
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CARRIER AUTHORITY AGREEMENT
ITS Financial Services, LLC agrees to fulfill the following requirements for the purpose of obtaining applicant’s motor carrier operating authority.
Applicant authorizes ITS Financial Services to act as its representative for this purpose. ITS Financial Services further agrees to fulfill these
requirements in a complete and timely manner.
These State Requirements for your base State:
IFTA-International Fuel Tax Agreement
IRP-International Registration Plan (apportioned tags)
UCR-Unified Carrier Registration (filing fee not included)
Simple Permits- NY, NM, KY, OR (on your behalf)
These Federal Requirements:
MC Number
US DOT Number
BOC-Process Agent
Once the Carrier’s authority is active, Truckstop.com® will provide access to the complete Carrier Package of services for a period of sixty (60)
days. The services and benefits include the following:
Unlimited Truck Posting
Unlimited Lane Posting
Unlimited Freight Searching
Bid Request Searching
Instant Notification
Match My Posted Truck
Access to F.M.C.S.A.
Credit Alerts
CreditStop Broker
CreditStop Broker Watch List
File Check
FuelDesk Plus
Fuel Stops on Route
Fuel Tax
Industry Alerts
Interactive Online Training
IT Magazine
Load Densities
Mileage Calculation
Missing/Stolen Alerts
Negotiation Strength
Pastwatch
Pintac
ProMiles Routing
Quick Post
Rate Index
Rate Trending
Road Conditions
Truckstop Directory
Weather Conditions
I, ________________________________, agrees to provide the requested information and signatures in an accurate and timely manner.
(Company or App licants Name Here)
Applicant will provide evidence of payment of the Federal Heavy Highway Vehicle Use Tax and be responsible for obtaining the required cargo
and liability insurance.
Principal/Applicants Signature:
Date:
ITS Financial Services, LLC Signature:
Date:
Payment Authorization
Company Name:
Applicants Name:
Applicants Email:
Please select which payment option you would like:
1. Charge my card $899 (Federal and State filing)
2. Charge my card $695 (Federal Filing only)
3. ___________________unique State Charges.
I authorize ITS Financial to use my card to pay the first year’s UCR Fee.
Credit Card Information:
Card Number :
Name of Card Owner:
Card Billing Address:
Visa
Mastercard
American Express
Card Expiration Date:
Discover
Security Code:
(month /year)
(3or4 digits)
(name on car d)
City:
St:
Zip:
What Happens Next?
Once payment is received we will obtain your new MC Number, as well as, your new USDOT number and your BOC-3 the same day.
In one to four business days your application will be published in the daily Federal Registry. At this point we will wait for the filing of your
insurance.
**Remember, the process can go no further until the insurance filing is complete and proof of payment for the Heavy Highway Vehicle Use Tax is
available.
Once your insurance is filed we will schedule a phone appointment to cover information specific to your base State. Following this we will begin
your base State’s filing requirements.
The entire process takes between five and seven weeks for most States at this time. We will keep you informed, by e-mail, as we progress
through each stage of the application. As always, we encourage you to call us of you have questions or concerns.
Once you authority is active and you are ready a representative with Truckstop.com will contact you to set up your trial account. At this point you
will have access to freight and be in business!
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Useful Links to Safety Certification Compliance
(save access to these links in your records as part of your safety compliance)
The internet link below connects with the Federal Motor Carrier Safety Regulations (FMCSR’s) at 49 CFR, (Parts 300-399):
https://www.fmcsa.dot.gov/regulations/title49/b/5/3
The internet link below connects with the Federal Motor Carrier Safety Administrations Hazardous Materials Transportation Regulations:
https://www.fmcsa.dot.gov/regulations/title49/b/5/3/list?filter=HazMat
The internet link below connects with the Federal Motor Carrier Safety Administrations regulations regarding an accident register (49 CFR Part 390.15):
https://www.fmcsa.dot.gov/regulations/title49/section/390.15
The internet link below connects with the U.S. Department of Transportation’s regulations regarding overseeing driver qualifications (49 CFR Part 391):
https://www.fmcsa.dot.gov/regulations/title49/part/391
The internet link below connects with the U.S. Department of Transportation’s regulations governing alcohol and controlled substances testing
requirements (49 CFR Part 382):
https://www.fmcsa.dot.gov/regulations/title49/part/382
The internet link below connects with the U.S. Department of Transportation’s regulations governing alcohol and controlled substances testing
requirements (49 CFR Part 40):
https://www.transportation.gov/odapc/part40
The internet link below connects with the U.S. Department of Transportation’s regulations governing driving and operational safety of motor vehicles
(49 CFR Parts 392, 395, and 396):
DRIVING OF COMMERCIAL MOTOR VEHICLES
https://www.fmcsa.dot.gov/regulations/title49/part/392
HOURS OF SERVICE OF DRIVERS
https://www.fmcsa.dot.gov/regulations/title49/part/395
INSPECTION, REPAIR, AND MAINTENANCE
https://www.fmcsa.dot.gov/regulations/title49/part/396
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