fill the forms Leave this field blank Status Apply New SCAC Renewal Legal Business Name Doing Business As Name (optional) Tax ID / Ein First Name Middle Name (optional) Last Name (optional) Title OwnerPresidentManagerOther Mode of Transportation PRVCAR - Private Motor Carriage or Private Rail Car CompanyAGENTS - Carrier Tariff Publishing BureauAIRLIN - Air Carrier or Air Taxi of any typeBINCDA - Passenger Motor Carrier operating in only CanadaBIMXCA - Passenger Motor Carrier operating only in Mexico or Central AmericaBINTRA - Passenger Motor Carrier with only Intrastate Operating AuthorityBROKER - Freight or Passenger Transportation Broker not Licensed by the FMCSABINCDA - Passenger Motor Carrier operating in only CanadaEXEMPT - Motor Freight Carrier Hauling Exempt CommoditiesFF-AIR - Air Freight ForwarderSFF - Surface Freight Forwarder Licensed by the FMCSAFRTFWD - Surface Freight Forwader not Licensed by the FMCSAGTC - Government Traffic Certificate issued by the former ICCLEASCO - Equipment Leasing CompanyLOCART - Local Cartage CompanyMINCDA - Motor Freight Carrier operating only in CanadaMINEUR - European Motor CarrierMINMEX - Motor Freight Carrier Operating only in Mexico or South AmericaMINTRA - Motor Freight Carrier Operating only within One StateNVOCC - Non-Vessel Operating Common CarrierRR-WTR - Railroad Cary FerryPIPELN - Pipeline CompanyRAILRD - RailroadRREQMK - Railroad Equipment MarkTVLAGT - Travel AgencyWCC - Water Carrier Certificate issued by the former ICCWATAGT - Steamship AgentWATRLN - Steamship Company, Barge Line, Automobile Ferry, etc. (if formerly licensed by the ICC provide WC Number above.)LOADBD - Load Board Email Address Contact Number Company Address Address Line 2 City Zip Code State -----Select State ------AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontWashingtonWest VirginiaWisconsinWyoming Mailing Address Same as Physical Address Mailing Address is Different Street Address (optional) Street Address Line 2 (optional) City (optional) Zip Code (optional) City (optional) State (optional) -----Select State ------AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontWashingtonWest VirginiaWisconsinWyoming Engine & Vehicle Information Vehicle Identification Number (VIN) Vehicle Model Vehicle Model Year 201820082009201020112012201320142015201620182017201920202021202220232024202520262027 State (optional) -----Select State ------AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontWashingtonWest VirginiaWisconsinWyoming Engine Manufacturer VolvoPaccarNissanMackFordDetroit DieselGeneral MotorsCaterpillarIsuzu9101112131415 Enter your active US DOT Number, MC Number, or FF Number issued by the U.S Dot Number MX Number FF Number Interstate Freight Forwarder Mc Number Mc Number Submitter Name Title PresidentManagerOwner Terms and Conditions* By submitting this form I certify that the above information is true and correct and I have reviewed and agree to the entire Send