Dot MC online fill the form Leave this field blank Company Name First Name Middle Name (Optional) Last Name Title -----Select State ------ President Owner Manager Other Form of Business * Applicant's Location -----Select State ------ United States New Mexico Canada Business form (Select the business form that applies) * Sole Proprietor / Individual Partnership Limited Liability Company (LLC) Corporation (State of Incorporation) Limited Liability Partnership (LLP) Trusts Other form of business Will the Applicant be crossing state lines or staying within one state? * Crossing State Lines Staying Within State Only Applicant will (check all that apply): * Transport Property (Hauling Goods / Items) Transport Passengers (Bus, Van, Limousine) Handle or Transport Hazardous Materials Provide Household Goods (HHG) Broker Services (Moving Companies) Provide General Freight Broker Services Provide Freight Forwarder Services Operate as an Intermodal Equipment Provider Other Applicant's Classification Please select all classifications of cargo that the applicant will transport or handle. General Freight Metal: Sheets, Coils, Rolls Drive Away/Tow Away Building Materials Machinery, Large Objects Passengers Livestock Coal/Coke Garbage, Refuse, Trash Chemicals Refrigerated Food Paper Product Farm Supplies Water Well Household Goods Motor Vehicles Logs, Poles, Beams, Lumber Mobile Homes Fresh Produce Intermodal Cont. Oil Field Equipment Grain, Feed, Hay Meat US Mail Commodities Dry Bulk Utility Construction Other Physical Address (P.O. Box will not be accepted) Address Line City Zip Code State -----Select State ------ Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Washington West Virginia Wisconsin Wyoming Employer Identification Number (EIN) or Social Security Number (SSN) Email only Mail Hard Copy EIN / TAX ID / Social Security (optional) Email Address Contact Number Mailing Address Address Line City Zip Code State -----Select State ------ Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Washington West Virginia Wisconsin Wyoming How Many Trucks How Many Trailers Drivers Details Who is filling the form ? * (optional) Acknowledgement Agreement 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 Send