Interstate Authority Application Form

Note: This application does not include federal or state fees. A service fee applies for each authority requested. Fees collected in this form will be applied toward your final invoice.

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 *

Authority Request Details

Type of Authority:

Common Carrier (For-Hire)
Broker Authority
Freight Forwarder Authority
Leasing Company Authority
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Requested Authority Start Date:

Requested Authority End Date (if applicable):

Number of Vehicles to Operate Under Authority:

Number of Drivers to Operate Under Authority:

Driver & Vehicle Information

For Each Driver and Vehicle,

Please complete the section below:

Driver#1 Details Below

Driver 1 Full Name: *

Driver 1 CDL Number: *

Driver 1 CDL State: *

Driver 1 Phone Number:

Vehicle #1 Details Below

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

Vehicle 1: VIN (Vehicle Identification Number): *

Vehicle 1: License Plate Number & State: *

Vehicle 1: State of Registration: *

Vehicle 1: Unit Number *

Vehicle 1 Type (e.g., Truck, Tractor, Bus): *

Vehicle 1 Registered Weight:

Driver #2 Details Below

Driver 2: Full Name:

Driver 2 CDL Number:

Driver 2 CDL State:

Driver 2 Phone Number:

Vehicle #2 Details Below

Vehicle 2: Year / Make / Model / Color:

Vehicle 2: VIN (Vehicle Identification Number):

Vehicle 2: License Plate Number & State:

Vehicle 2: State of Registration:

Vehicle 2: Unit Number

Vehicle 2 Type (e.g., Truck, Tractor, Bus):

Vehicle 2 Registered Weight:

Driver #3 Details Below

Driver 3: Full Name:

Driver 3 CDL Number:

Driver 3 CDL State:

Driver 3 Phone Number:

Vehicle #3 Details Below

Vehicle 3: Year / Make / Model / Color:

Vehicle 3: VIN (Vehicle Identification Number):

Vehicle 3: License Plate Number & State:

Vehicle 3: State of Registration:

Vehicle 3: Unit Number

Vehicle 3 Type (e.g., Truck, Tractor, Bus):

Vehicle 3 Registered Weight:

Schedule a Consultation for more than 3 Trucks/Drivers?

Yes
No
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Supporting Documents

Please upload clear copies of the following:

Proof of Insurance (Cargo & Liability)

Vehicle Registration

Driver CDL Copies

Existing Authority (if updating)

Any Special Federal Forms (if required)

Other Supporting Documents

Service Fee:

New Interstate Authority Enrollment: $400
Annual Renewal: $300
Update / Amendment to Existing Authority: $150
Compliance Consultation: $200/hour

Pay the service fee now to get started — final pricing may adjust based on your authority type, vehicles, and drivers, and federal/state fees are billed separately. Please enter your payment details below to complete your request. *

$ 400

$ 300

$ 150

$ 200

*100% secure & safe payments*

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