Obtain a 5 Day Permit

Motor Carrier Information

The information that this page requires is found on the form submitted by the taxpayer.

5 Day Permit Request Elements Label Description
Start Date: End Date:	Calendar To enter the Start Date, enter the date information into the data fields or press the calendar icon and select the effective date. The calendar opens to the current date. To change months, use the scroll arrows (<< or >>). Click the date needed and it will be imported into the form. Note: The End Date will be calculated and provided by the system.
Vehicle Unit Number:	Data Field Enter the vehicle unit number.
Vehicle Plate Number:	Data Field Enter the vehicle plate number.
State:	State Enter the appropriate two-letter Jurisdiction code.
Vehicle Identification Number:	Data Field Enter the vehicle identification number.
Company Name:	Data Field Enter the business company name.
Doing Business As (DBA):	Data Field If the company has a DBA name, enter it in this data field.
Federal Identification:	Radio Buttons and Data Field (numbers) Select the radio button for either FEIN or SSN. Enter the FEIN or SSN number (that matches the button selection) in the data field.
US DOT#	US DOT Enter the US DOT number.
Ordered by:	Data Field (name) Enter the name of the responsible individual.
Telephone Number:	Data Field (phone) Enter the area code in the first field. Enter the phone number prefix in the second field. Enter the last four digits of the number in the third field.
Street Address	address Enter the full street address in the data field.
City:	City Enter the name of the city
State:	State Use the two-letter Jurisdiction abbreviation for the state.
Zip Code:	Zip code Enter the zip code in the data field.
Permit Application signed by Taxpayer?	Radio Buttons Select the radio button marked Yes if the application is signed by the taxpayer. Select the No button if it is not signed by the taxpayer.
Additional Details:	Data Field (text) Any further information may be entered in the data field.
Submit	Button Press the Submit button to proceed with the new account registration.

5 Day Permit Request Elements

Label Description

Start Date:

End Date:

Calendar

To enter the Start Date, enter the date information into the data fields or press the calendar icon and select the effective date. The calendar opens to the current date. To change months, use the scroll arrows (<< or >>). Click the date needed and it will be imported into the form.

Note:

The End Date will be calculated and provided by the system.

Vehicle Unit Number:

Data Field

Enter the vehicle unit number.

Vehicle Plate Number:

Data Field

Enter the vehicle plate number.

State:

State

Enter the appropriate two-letter Jurisdiction code.

Vehicle Identification Number:

Data Field

Enter the vehicle identification number.

Company Name:

Data Field

Enter the business company name.

Doing Business As (DBA):

Data Field

If the company has a DBA name, enter it in this data field.

Federal Identification:

Radio Buttons and Data Field (numbers)

Select the radio button for either FEIN or SSN. Enter the FEIN or SSN number (that matches the button selection) in the data field.

US DOT#

US DOT

Enter the US DOT number.

Ordered by:

Data Field (name)

Enter the name of the responsible individual.

Telephone Number:

Data Field (phone)

Enter the area code in the first field. Enter the phone number prefix in the second field. Enter the last four digits of the number in the third field.

Street Address

address

Enter the full street address in the data field.

City:

City

Enter the name of the city

State:

State

Use the two-letter Jurisdiction abbreviation for the state.

Zip Code:

Zip code

Enter the zip code in the data field.

Permit Application signed by Taxpayer?

Radio Buttons

Select the radio button marked Yes if the application is signed by the taxpayer. Select the No button if it is not signed by the taxpayer.

Additional Details:

Data Field (text)

Any further information may be entered in the data field.

Submit

Button

Press the Submit button to proceed with the new account registration.