Contact Us - Intake Form - DOT Authority Permits

Full Name (Owner/Applicant)

Phone Number

Email Address

Preferred Method of Contact:

Desired Business Name (LLC Name):

Backup Name Options (if first is unavailable)

Business Address (No PO Box):

Mailing Address (if different):

Business Phone Number:

Business Email (if different from personal):

State for LLC Formation

Single-Member or Multi-Member LLC?

Single Member Multi-Member

Member(s) Full Name(s):

Social Security Number (For IRS Verification) - This is required for EIN application. Information is kept confidential.

Are you a U.S. Citizen or Resident Alien?

Yes No

Primary Business Activity

Type of Operation:

Interstate Intrastate

Number of Commercial Vehicles

Number of Drivers (including yourself)

Are any drivers operating CDL vehicles?

Yes No

Vehicle Information (Year/Make/Model/Weight Class)

Name of Person Authorizing BOC-3:

Number of Commercial Motor Vehicles (CMVs):

State where vehicles are primarily based:

Additional Notes or Special Requests

Disclaimer & Consent

By submitting this form, you confirm that all information provided is true, complete, and accurate to the best of your knowledge. DOT AUTHORITY PERMITS INC. is not responsible for errors, delays, or penalties resulting from incorrect, incomplete, or misspelled information submitted by the client. We are a private third-party service provider and are not affiliated with any government agency (including USDOT, FMCSA, IRS, or the UCR Plan). You are not required to use our services and may complete filings directly with the appropriate government agencies via their official websites. All information submitted through this form is considered confidential and sensitive. It will not be shared, sold, or disclosed to any third party without your consent, except when required to complete filings authorized by you. By submitting this form, you authorize DOT AUTHORITY PERMITS INC. to prepare and file documents on your behalf using the information you have provided.

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