Type the name, in the space provided, of the individual authorized to sign documents on behalf of the MOTOR CARRIER/HM SHIPPER listed in the first field of the form. That individual must sign the online form (your credit card number acts as the signature), and enter his or her title in the spaces provided (Certification Statement, see 49 CFR 390.19). The date is generated automatically.
This statement certifies that you are familiar with the Federal Motor Carrier Safety Regulations and/or the Federal Hazardous Materials Regulations. NOTE: Under penalties of perjury, you are declaring that the information that you entered on this report is, to the best of your knowledge and belief, true, correct, and complete.
After completing the Certification Statement, click SUBMIT to apply for your U.S. DOT number.
Click RESET to erase the data you have entered and start over.