Trip / Fuel Permit Application

Note: This application does not include state fees. A $40 service fee applies per permit; applicable state permit costs will be billed separately.

Legal Business Name: *

Doing Business As:

DOT Number: *

FEIN / Tax ID:

Primary Contact Name: *

Contact Phone Number *

Contact Email Address *

Business Address *

Permit Details

Trip or Fuel Permit Type: *

Trip Permit (Temporary travel authority)
Fuel Permit (Temporary IFTA replacement)
Both Trip & Fuel Permit
No elements found. Consider changing the search query.
List is empty.

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
No elements found. Consider changing the search query.
List is empty.

Number of Permits Requested:

Vehicle Use Type: *

Interstate (Traveling across state lines)
Intrastate (Traveling only within Connecticut)
No elements found. Consider changing the search query.
List is empty.

Start Date of Permit: *

End Date of Permit (if known): *

Is This Permit for a Leased Vehicle? *

Yes
No
No elements found. Consider changing the search query.
List is empty.

If Yes, Provide Lessor Company Name:

Vehicle 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: Fuel Type: *

Diesel
Gasoline
CNG
Electric
Other
No elements found. Consider changing the search query.
List is empty.

Gross Vehicle 1 Weight Rating (GVWR):

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

Has vehicle 1 operated in California? (Yes/No): *

Yes
No
No elements found. Consider changing the search query.
List is empty.

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: Fuel Type:

Diesel
Gasoline
CNG
Electric
Other
No elements found. Consider changing the search query.
List is empty.

 Gross Taxable Weight Vehicle 2 (GVWR):

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

Has vehicle 2 operated in California? (Yes/No):

Yes
No
No elements found. Consider changing the search query.
List is empty.

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: Fuel Type:

Diesel
Gasoline
CNG
Electric
Other
No elements found. Consider changing the search query.
List is empty.

 Gross Taxable Weight Vehicle 3 (GVWR):

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

Has vehicle 3 operated in California? (Yes/No):

Yes
No
No elements found. Consider changing the search query.
List is empty.

List Any Additional Vehicles Below

Supporting Documents

Please upload clear copies of the following:

Proof of USDOT Number

Vehicle Registration(s)

Other Supporting Documents

Service Fee:

1 Permit – $40
2 Permits – $80
3 Permits – $120

State fees are additional and billed separately.

Please submit your payment based on how many requested permits above to begin your Trip/ Fuel Application and enter your payment details below to complete your request. *

$ 40

$ 80

$ 120

*100% secure & safe payments*

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to (XXX) XXX-XXXX for assistance. You can reply STOP to unsubscribe at any time.

Privacy Policy | Terms of Service