Carrier Application Form

Collect the operational, fleet, and insurance details of a trucking company applying to work with you.

Use this template

Application Date

Company Name

Entity Type

Founded Date

US DOT #

MC #

Company Phone Number

Company Email

Company Website

Company Address

Dirección

Ciudad

Estado / Provincia

Código postal

What are the services offered?

What are the available equipment, tools, machines, etc.?

Contact Person Name

Nombre

Apellido

Contact Person Job Title

Contact Person Phone Number

Contact Person Email Address

Does the trucks have the company logo at the back?

Yes No

Does your company have a storage facility?

Yes No

Is it temporary or permanent?

Temporary Permanent

Does your company provide shippers additional insurance?

Yes No

What type of insurance do you offer?

Do you belong to any registered moving associations or moving clubs?

Yes No

Do you hire other companies (transportation/subcontractors) for deliveries?

Yes No

Please upload the following documents: W9/W8, signed non-disclosure agreement, signed contract, insurance certificate, birth certificate, and other supporting documents

Max 10 MB per file

Please upload the following documents: Tariff, Arbitration Policy, Loss/Damage Claim Form

Max 10 MB per file

Was there any previous history about your license being revoked?

Yes No

Please provide more details about that situation

Authorized Signature

Sign here

Date Signed

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Carrier Application Form

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