UCR, Unified Carrier Registration, UCR Tax

USDOT# Number:

Email address:

Business Phone Number:

Mobile* is the Same as Business Phone.

Mobile Phone Number:

Registration year:

I certify that I have been given proper authorization to perform or modify UCR registration information for USDOT for 2023.

I agree that my business is subject to UCR.

Contact person full name:

Legal name:

DBA:

Physical country:

Physical state:

Physical city:

Physical address:

Physical zip code:

Mailing Address is the Same as Physical Address.

Mailing country:

Mailing state:

Mailing city:

Mailing address:

Mailing zip code:

Billing Address is the Same as Physical Address.

Billing country:

Billing state:

Billing city:

Billing address:

Billing zip code:

Are you updating any of the company's Operations Classification?

Auth. For Hire:

Priv. Pass.(Non-business):

State Gov:

Exempt For Hire:

Migrant:

Local Gov:

Private(Property):

U.S. Mail:

Indian Nation:

Priv. Pass. (Business):

Fed. Gov:

IEP:

Motor Carrier (For Hire):

Motor Private Carrier (Not For Hire):

Freight Forwarder:

Broker:

Leasing Company:

Vehicles:

Straight trucks tractors:

Passenger vehicles:

Additional vehicles:

Vehicle total:

I certify that I am the authorized holder and signer of the credit card reference above. I certify that all information above is complete and accurate.

I hereby authorize collection of payment for all charges as indicated above. Charges may not exceed the amount listed above in the “TOTAL COST” field. I understand this is only for up to this amount on the date listed below in the "DATE SIGNED" field. If additional charges are going to be authorized a new form will have to be completed.

The “TOTAL COST” includes all Federal, State and Local Government fees.

I hereby, acknowledge and agree that after the charges are authorized a DOT OPERATIONS INC agent is assigned in 15 minutes to run the order. Once the agent is assigned the charges become non-refundable.

By continuing with the registration process, you are certifying that all provided information is accurate and up-to-date. Permitting delays, fines, and/or additional fees may result from the submission of incorrect or inaccurate information. Furthermore, you agree to pay the total amount shown above with your selected payment method. Failure to produce the required funds or stop payments of funds may result in delays, fines, or additional fees.

Signature:

I agree with Privacy Policy and Terms and conditions

UCR Registration

USDOT#:

Confirm Your Official Representative

Your signature: