Reinstatement Authority Application Form

Note: This application does not include federal or state fees. A $350 base fee applies for processing the reinstatement of your authority.

Legal Business Name: *

Primary Contact Name: *

Contact Phone Number *

Contact Email Address *

Business Address *

Authority Information

Type of Reinstatement: *

Carrier Authority – $350
Broker Authority – $350
Freight Forwarder Authority – $400
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USDOT Number *

MC/MX Number (if applicable):

Reason for Reinstatement: *

Type of Operation: Interstate or Intrastate

Interstate
Intrastate
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Hazmat Transport:

Yes
No
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Driver & Vehicle Information

Number of Power Units:

Number of Drivers:

Number of Trailers / Special Equipment:

Primary Vehicle Types:

Tractor-Trailer
Straight Truck
Bus / Passenger Vehicle
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For Each Driver and Vehicle,

Please complete the section below:

Each Additional Vehicle (beyond 1): $50/vehicle

Each Additional Driver (beyond 1): $25/driver

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

Copy of Driver’s License

Vehicle Registration

Other Supporting Documents

Service Fee:

Carrier Authority - $350
Broker Authority - $350
Freight Forwarder Authority - $400
Additional Vehicle $50
Additional Driver $25

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

$ 350

$ 50

$ 25

*100% secure & safe payments*

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