I hereby declare that I am the applicant and the person completing this form for Clearing House registration for myself. I confirm that the execution of this document is my voluntary act and deed.

I certify that I am familiar with the Federal Motor Carrier Safety Regulations and, if applicable, the Federal 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 offence. 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 offence I certify that the information I provided in this form is true and accurate. By clicking this I understand the terms and conditions as presented on this site. I authorize the owner of this website to generate a login.gov account on my behalf to process my application for a DOT number on my behalf (including representing on my behalf to the FMCSA the information that I provide via the form and through subsequent communications,) and to contact me about my application and related services. By submitting I agree to the Terms, Privacy Policy, Refund Policy and agree to receive text messages related to my application process

I confirm that all the information provided in this form is true and correct to the best of my knowledge.

I understand that the government may approve or authorize any required tax or permit-related processes as part of this filing. I authorize all applicable government fees to be charged to my card. I also acknowledge that I am paying the service fees for this filing online.

By submitting this form, I agree to the Privacy policyand Terms and Conditions. of Tax2Permit