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1. Private Commercial Carrier - Non Hazardous

1. Private Commercial Carrier - Non Hazardous

Enter 'Yes' if you need a USDOT Number as a Private Commercial Motor Carrier, not-for-hire, hauling your own products
2. The State (or the main state) your Business is located in

2. The State (or the main state) your Business is located in

Please spell out the entire name of your state and do not abbreviate the name.
3. Maximum Extent of Operations

3. Maximum Extent of Operations

If you will be crossing state lines, enter 'Yes' in the box - otherwise leave the box blank
4. Intrastate Operation

4. Intrastate Operation

If you are not going to cross state lines and will remain in the state with your truck or trucks, enter 'Yes' - otherwise leave the box blank
5. Enter 'No' if you do not carry carry Hazardous Materials

5. Enter 'No' if you do not carry carry Hazardous Materials

Enter 'No' as you will not be carrying Hazardous Materials requiring placarding. You will not be For-Hire and you will be hauling only your own products.
6. All trucks with a Gross Vehicle Weight Rating of less than 10,000-lbs

6. All trucks with a Gross Vehicle Weight Rating of less than 10,000-lbs

If you need a USDOT Number and none of your trucks have a Gross Vehicle Weight Rating (GVWR) of 10,000-lbs or more stamped on the door jamb, enter 'Yes' - otherwise leave the box blank.
7. One of more trucks have a GVWR of 10,000-lbs or more

7. One of more trucks have a GVWR of 10,000-lbs or more

If your truck, or if one of your trucks has a Gross Vehicle Weight Rating (GVWR) of 10,000-lbs or more, OR, if you will be pulling a trailer where the COMBINED Gross Vehicle Weight Ratings of the truck and the trailer are 10,000-lbs or more, enter 'Yes' - otherwise leave the box blank.
8. Name of Company Official or Owner

8. Name of Company Official or Owner

Please enter your first name, Middle Initial and Last Name
9. Title of Company Official or Owner

9. Title of Company Official or Owner

If your company is a Corporation, enter 'President' or 'Secretary Treasurer'. If the company is an LLC, enter 'Member'. If you are the owner and the business is neither a Corporation nor an LLC, enter 'Owner'
10. Legal Name

10. Legal Name

Enter your personal name if you are the 'Owner'. If the company is a Corporation or LLC, enter the full name of the Corporation or LLC
11. 'Doing Business As' name, or d/b/a name

11. 'Doing Business As' name, or d/b/a name

If the legal name is your personal name and you are not using a Corporate name or an LLC name, you can use a 'Doing Business As' name, or d/b/a name. If you want to use a d/b/a name, the d/b/a name will follow your personal name such as John Smith d/b/a Smith Transport, or John Smith d/b/a JS Transport. If you want to use a d/b/a name, do not enter your personal name in the box below, type in only the d/b/a name you would like to use for your business.
12. Physical Address - Street

12. Physical Address - Street

In addition to your physical address, if you have a separate mailing address, you can enter the mailing address in box # 20 below. We still need your physical address to be entered in the box below
13. City

13. City
14. County

14. County
15. State

15. State

Please spell out the entire name of your state and do not abbreviate the state name
16. Zip Code

16. Zip Code
17. Phone Number

17. Phone Number
18. Cell Phone #

18. Cell Phone #
19. Fax Number

19. Fax Number
20. Mailing Address - P.O. Box, or Different Street Address

20. Mailing Address - P.O. Box, or Different Street Address
21. City

21. City
22. State

22. State

Please spell out the entire name of your state and not abbreviate the state name
23. Zip Code

23. Zip Code
24. EIN Federal ID Number

24. EIN Federal ID Number

If you have a Federal ID Number and know this number, please enter the number in the box below. If you are a corporation or an LLC, we will need this number. The number is a two digit number followed by a dash and seven digits (12-3456789). If you are a Corporation or an LLC and you do not have this Federal ID Number, call us and we can apply for a number. If your truck, or tractor and trailer combination is over 54,000-lbs loaded, you will need an EIN for your 2290 Highway Use Tax
25. Social Security Number

25. Social Security Number

Your Social Security Number is not needed if you are a Corporation or an LLC
26. E-Mail address

26. E-Mail address
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Greatlakes@gls.comcastbiz.net

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