Get Your MC/DOT/UCR FiledClick Here To File On Your Own Have Us File Your MC/DOT/UCR for $824 BROKER AUTHORITY QUESTIONNAIRE To receive your MC Number and DOT Number with United Carrier Registration Once you have received your MC/DOT numbers be sure to obtain your bond to ensure your authority goes active. The FMCSA now only allows 90 days to comply with the bond requirements before dismissing the authority Note: Please fill out completely and accurately to ensure no delays or change fees on your issued Broker MC/DOT Numbers. Also make sure your addresses are not virtual or po box. Company Information Legal Company Name Legal Business Structure -- Select -- LLC INC Sole Proprietorship State Of Incorporation AKALARASAZCACOCTDCDEFLGAGUHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUMUTVAVIVTWAWIWVWY DBA (Doing Business As) Company Address Address Line 1 City Company Address: AKALARASAZCACOCTDCDEFLGAGUHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUMUTVAVIVTWAWIWVWY ZIP Code: Country: United States Contact Information Company Phone Number EIN/SSN? -- Select -- EIN SSN Company EIN Tax ID Number Or SSN Owner(s) / Company Officer(s) Information Owner 1: Owner's Name Phone/Mobile Owner's Title Email Owner Mailing Address Address Line 1 City Mailing Address: AKALARASAZCACOCTDCDEFLGAGUHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUMUTVAVIVTWAWIWVWY ZIP Code: Mailing Country: United States Citizenship Information Are you a US Citizen? (If NO select country below) Yes No CitizenCountry: Service Selection What will you be brokering? -- Select -- General Freight Household Goods Previous Experience Have you ever had a MC/DOT or been associated with one in the past 3 yrs? Yes No If Yes, then what was the MC/DOT Number? Will you operate both Interstate and Intrastate Authority? Both Interstate Only Intrastate Only Will you handle Hazardous Materials? Yes No Important Note You will get a certificate of authority when you go active. It's mailed from FMCSA to your physical address. It arrives 7 to 10 days after you go active. The certificate does reflect the physical address also. Basic Broker Package: you will be taken to the payment page after submitting. Submit
