Special State Permit Application Form

Note: This application does not include state fees. A service fee applies for per permit.

This fee does not include state fees; applicable state permit costs will be billed separately.

Legal Business Name: *

Doing Business As:

DOT Number: *

MC/MX Number (if applicable):

FEIN / Tax ID:

Primary Contact Name: *

Contact Phone Number *

Contact Email Address *

Business Address *

Permit Request Details

Special State Permit Type: *

Oversize
Overweight
Hazardous Material
Other (please specify)
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State of Travel: *

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
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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Number of Permits Requested: (select one) *

1
2
3
More than 3 – Please Contact Us
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Vehicle / Load Information

For Each Vehicle, Please complete the section below:

Vehicle #1 Details Below

Vehicle 1: Year / Make / Model / Color: *

Vehicle 1: VIN (Vehicle Identification Number): *

Vehicle 1: License Plate Number & State: *

Vehicle 1: Current Mileage: *

Vehicle 1: State of Registration: *

Vehicle 1: Unit Number

Gross Vehicle 1 Weight Rating (GVWR):

Load Details 1

Load Description 1:

Overall Load Length 1:

Overall Load Height 1:

Overall Load Width 1:

Load Weight 1:

Load Details 1 - Origin Address 1:

Load Details 1 - Destination Address 2:

Travel Dates Requested 1:

Vehicle #2 Details Below

Vehicle 2: Year / Make / Model / Color:

Vehicle 2: VIN (Vehicle Identification Number):

Vehicle 2: License Plate Number & State:

Vehicle 2: Current Mileage:

Vehicle 2: State of Registration:

Vehicle 2: Unit Number

 Gross Taxable Weight Vehicle 2 (GVWR):

Load Details 2

Load Description 2:

Overall Length 2:

Overall Width 2:

Overall Height 2:

Load Weight 2:

Load Details 2 - Origin Address 1:

Load Details 2 - Destination Address 2:

Travel Dates Requested 2:

Vehicle #3 Details Below

Vehicle 3: Year / Make / Model / Color:

Vehicle 3: VIN (Vehicle Identification Number):

Vehicle 3: License Plate Number & State:

Vehicle 3: Current Mileage:

Vehicle 3: State of Registration:

Vehicle 3: Unit Number

 Gross Taxable Weight Vehicle 3 (GVWR):

Load Details 3

Load Description 3:

Overall Length 3:

Overall Width 3:

Overall Height 3:

Load Weight 3:

Load Details 3 - Origin Address 1:

Load Details 3 - Destination Address 2:

Travel Dates Requested 3:

Schedule a Consultation for more than 3 permits?

Yes
No
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Supporting Documents

Please upload clear copies of the following:

Proof of Insurance

Proof of USDOT Number

Vehicle Registration(s)

Load Diagram or Drawing (if available)

Any Special State Forms (if required)