Form Op-1 - Application For Motor Property Carrier And Broker Authority
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1
2Application For Motor Property Carrier and Broker Authority
FORM OP-1
1. Legal Business Name: ________________________________________________________________________
2. Doing Business As (DBA): ____________________________________________________________________
3. Street Address: _____________________________________________________________________________
4. Billing Address: _____________________________________________________________________________
5. City _______________________________State ______ Zip________________________
6. Telephone _________________________
7. USDOT Number: ___________________________________________________________
8. Form of Business:
☐ Sole Proprietorship (enter full name of individual): ________________________________________________
☐ Corporation (enter state or province where incorporated): __________________________________________
☐ Partnership (enter full name and title of each partners):
___________________________________
_____________________________________
Name
Title
___________________________________
______________________________________
Name
Title
___________________________________
______________________________________
Name
Title
9. NATURE OF GOVERNMENTAL FINANCIAL ASSISTANCE YOU RECEIVE, IF ANY
☐ Public Recipient
☐ Private Recipient
☐ Non-recipient
10. Scope of Operating Authority (check all that apply)
☐
CHARTER AND SPECIAL TRANSPORTATION, in interstate or foreign commerce, between points in the United States.
☐
CHARTER AND SPECIAL TRANSPORTATION, between points in the United States, provided by United States-based enterprises
owned or controlled by persons of Mexico
☐
SERVICE OVER REGULAR ROUTES. (A regular route passenger carrier performs regularly scheduled service and is not required
to submit specific regular routes.) Regular route passenger service includes authority to transport newspapers, baggage of passengers,
express packages, and mail in the same motor vehicle with passengers, or baggage of passengers in a
separate motor vehicle
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