US DOT Number Form

US DOT 150 Application

Reason for Filing (Mark Only One)
- New Application
- Biennial Update or Changes
- Out of Business Notification
- Reapplication (After Revocation of New Entrant)
Business Information
Name of Motor Carrier
First Last
Trade or DBA (Doing Business As) Name
Principal Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Mailing Address (if different)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Contact information
Phone
Cell Phone
Fax
Email
Business Numbers
US DOT Number
MC or MX Number
Dun & Bradstreet Number
IRS/Tax ID Number
EIN
SSN
Company Operation (Mark all that apply)
- Interstate Carrier
- Interstate Hazmat Carrier
- Interstate Non- Hazmat Carrier
- Interstate Hazmat Shipper
- Vehicle Registrant Only
Operation Classification
- Authorized For-Hire
- Exempt For-Hire
- Private Property
- Private Passengers (Business)
- Private Passengers (Non- Business)
- Migrant
- US Mail
- Federal Government
- State Government
- Local Government
- Indian Tribe
- Other
If "Other" please describe
Hazardous Materials (Carrier or Shipper, mark all that apply)
(C) Carrier (S) Shipper (B) Bulk - In Cargo Tanks (NB) Non-Bulk in Packages
DIV 1.1
- C
- S
- B
- NB
DIV 1.2
- C
- S
- B
- NB
DIV 1.3
- C
- S
- B
- NB
DIV 1.4
- C
- S
- B
- NB
DIV 1.5
- C
- S
- B
- NB
DIV 1.6
- C
- S
- B
- NB
DIV 2.1 (Flam, Gas)
- C
- S
- B
- NB
DIV 2.1 (LPG)
- C
- S
- B
- NB
DIV 2.1 (Methane)
- C
- S
- B
- NB
DIV 2.2
- C
- S
- B
- NB
DIV 2.2 D
- C
- S
- B
- NB
DIV 2.3 A
- C
- S
- B
- NB
DIV 2.3 B
- C
- S
- B
- NB
DIV 2.3 C
- C
- S
- B
- NB
DIV 2.3 D
- C
- S
- B
- NB
DIV 3
- C
- S
- B
- NB
DIV 3A
- C
- S
- B
- NB
DIV 3B
- C
- S
- B
- NB
COMB LIQ
- C
- S
- B
- NB
DIV 4.1
- C
- S
- B
- NB
DIV 4.2
- C
- S
- B
- NB
DIV 4.3
- C
- S
- B
- NB
DIV 5.1
- C
- S
- B
- NB
DIV 5.2
- C
- S
- B
- NB
DIV 6.2
- C
- S
- B
- NB
DIV 6.1A
- C
- S
- B
- NB
DIV 6.1B
- C
- S
- B
- NB
DIV 6.1 Poison
- C
- S
- B
- NB
DIV 6.1 Solid
- C
- S
- B
- NB
Class 7
- C
- S
- B
- NB
HRCQ
- C
- S
- B
- NB
Class 8
- C
- S
- B
- NB
Class 8A
- C
- S
- B
- NB
Class 8B
- C
- S
- B
- NB
Class 9
- C
- S
- B
- NB
Elevated Temp. Mat.
- C
- S
- B
- NB
Infectious Waste
- C
- S
- B
- NB
Marine Pollutants
- C
- S
- B
- NB
Hazardous Sub (RQ)
- C
- S
- B
- NB
Hazardous Waste
- C
- S
- B
- NB
ORM
- C
- S
- B
- NB
Number of Vehicles that will be Operated in the US
Owned
Straight Trucks Truck Tractors Hazmat Cargo Tank Trucks Hazmat Cargo Tank Trailers Motorcoach
Term Leased
Straight Trucks Truck Tractors Hazmat Cargo Tank Trucks Hazmat Cargo Tank Trailers Motorcoach
Trip Leased
Straight Trucks Truck Tractors Hazmat Cargo Tank Trucks Hazmat Cargo Tank Trailers Motorcoach
Number of Vehicles Carrying number of Passengers (including the driver)
Owned
School Bus 1-8 School Bus 9-15 School Bus 16+ Mini-bus 16+ Passenger Van 1-8 Passenger Van 9-15 Limosine 1-8 Limosine 9-15 Limosine 16+
Term Leased
School Bus 1-8 School Bus 9-15 School Bus 16+ Mini-bus 16+ Passenger Van 1-8 Passenger Van 9-15 Limosine 1-8 Limosine 9-15 Limosine 16+
Trip Leased
School Bus 1-8 School Bus 9-15 School Bus 16+ Mini-bus 16+ Passenger Van 1-8 Passenger Van 9-15 Limosine 1-8 Limosine 9-15 Limosine 16+
Driver Information
Within 100 mile Radius
Interstate Intrastate
Beyond 100 mile Radius
Interstate Intrastate
Total Drivers
Total CDL Drivers
Is Your USDOT Number Registration Currently Revoked by the Federal Motor Carrier Safety Administration
- Yes
- No
If Yes, enter your USDOT Number
Please Enter Name(s) of Sole Proprietor(s), Officers or Partners and Titles
(e.g. President, Treasurer, General Partner, Limited Partner)
Name
First Last
Name
First Last
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