Secure Online Application for Oversized/Overweight Permit Processing
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 COMPANY INFORMATION
Motor Carrier's Name
Motor Carrier's Address
Telephone Number
Fax Number
 
Email Address
Contact Name
ICC Number
Federal Tax ID Number
US DOT Number
   
 PERMIT INFORMATION
Permit(s) Being Ordered for Which State(s)  
Type of Permit(s) Is Insurance on File (if applicable)?
Requested Start Date Number of Pieces
   
 LOAD INFORMATION
Load Description  
Year/Make/Model/Serial Number of Load (if applicable)
Dimensions of Load (Length, Width, Height)  
   
POWER UNIT (TRUCK) INFORMATION
Unit Number (if applicable) Year
Manufacturer (Make) Model
VIN (Serial) Number of Power Unit (Truck) License Plate Number
State of Jurisdiction of License Plate Registered Weight
Number of Axles on Power Unit  
 
   
TRAILER INFORMATION
Unit Number (if applicable) Year
Manufacturer (Make) Model
License Plate Number State or Jurisdiction of License Plate
Number of Axles on Trailer VIN#
Trailer Length  
 
   
DIMENSIONS (Please enter feet and inches)
Overall Length (of combination) Length of Trailer and Load
Overall Width Overall Height
Front Overhang (if applicable) Rear Overhang (if applicable)
   
WEIGHTS
Gross Weight  
 
   
AXLE WEIGHTS (Enter lbs.)
Axle 1 Axle 2
Axle 3 Axle 4
Axle 5 Axle 6
Axle 7 Axle 8
   
AXLE SPACINGS (Enter feet and inches)
Axle 1 to 2 Axle 2 to 3
Axle 3 to 4 Axle 4 to 5
Axle 5 to 6 Axle 6 to 7
Axle 7 to 8  
 
   
TRIP INFORMATION
Specific Address of Trip Origin
Specific Address of Trip Destination
Permit Origin (State Line, etc.)
Routes (Please be as specific as possible using route numbers and directions (North, South, etc.)
Will you accept route changes from the State (yes/no)
If yes, how many miles off requested route will you accept?
   
Questions about this form?
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