AUTHORITY APPLICATION

AtBLUE RIDGE TM LLC you can get everything you need to completely set up and operate your own trucking or freight brokerage company

Authority Application

Trucking Authority

Please fill out as accurately as possible and press the submit button at the bottom

Owners Name:
Owners SSN:
Address of Owner:
Owners City:
State:
Owners Zip Code:
Owners Phone Number:
Legal Business Name - If filing as a sole proprietor then list the name of the owner as Legal Business Name and list the business name in the DBA:
DBA (Doing Business As):
Business Address:
Business City:
State:
Business Zip Code:
Business County:
Business Mailing Address if different than business address:
Business Phone Number:
Business Fax Number:
Business Email address:
Type of Business:
IF you chose corporation then list which state papers were filed in:
If partnership then list full name of all partners:
Type of Authority needed:
HAve you ever had a US DOT Number before?:
If you answered yes to having a US DOT Number then list the number and the PIN number:
Will you cross state lines?:
Will you be For-Hire:
What is your GVWR (Gross Vehicle Weight):
Have you ever been convicted after Sept1,1989 of any Federal or State offenses involving the distribution of a controlled substance?:
Number of straight trucks:
Number of Trucks/Tractors:
Number of trailers:
Number of CDL Drivers:
Number of drivers that will stay within state lines:
Number of drivers that will cross state lines:
Type of Freight hauled		General Freight
		Household goods
		Metal, Sheets, Coils, Rolls
		Motor Vehicles
		Drive Away/ Tow Away
		Logs, Poles, Beams, Lumber
		Building Materials
		Mobile Homes
		Machinery, Large Objects
		Fresh Produce
		Liquids/ Gases
		Intermodel Containers
		Passengers
		Oil Field Equipment
		Livestock
		Grain, Feed, Hay
		Coal/ Coke
		Meat
		Garbage, Refuse, Trash
		US Mail
		Chemicals
		Dry Bulk Commodities
		Refrigerated Food
		Beverages
		Paper Products
		Utility
		Farm Supplies
		Construction
		Water Well
Other:
Do you need a Kentucky KYU number:
Do you need a New York Hut Permit:
Do you need a New Mexico permit:
The information that has been provided is true and accurate - please place name here:
Fed ID/EIN #:
Email Address:
Unit Number:
Year:
Make:
Leased or Owned:
Plate Number:
State Licensed In:
Full VIN Number: