Fillable Mv Irp-B - Mileage Schelude Template (Page 2 of 2) in pdf

MILEAGE SCHEDULE INSTRUCTIONS

RENEWAL MONTH/LICENSE YEAR: the renewal month and

TYPE OF OPERATION (Check One)

license year for which you are registering. Renewal month will

be assigned to new applicants.

For Hire Exempt – Hauls property exempt from federal regu-

lation when it crosses jurisdiction lines.

ACCOUNT NUMBER: the account number assigned by the

For Hire – Hauls FMCSA regulated property for common or

Motor Vehicle Division.

contract carriers.

Private – Hauls your own property.

FLEET NUMBER: the two digit fleet number assigned by the

Common Carrier – Has FMCSA authority to haul for anyone

Motor Vehicle Division

at any time.

Contract Carrier – Has FMCSA authority to haul only under

REGISTRANT NAME: the legal name of the person, firm, or

contract.

corporation in which the account is registered.

For Hire Rental – Has a fleet of vehicles to be rented to

others.

DBA NAME: the name in which the registrant is Doing Busi-

ness As (DBA).

COMMODITY CLASS (Check One)

All – Any type of property/commodities.

CONTACT PERSON: name, telephone number, fax number,

and e-mail address of the person who is authorized to conduct

Exempt – Anything not regulated by the FMCSA.

business on behalf of the registrant.

Logs – Trees cut from the forest with the branches and roots

removed.

BUSINESS ADDRESS: the street or highway and building

Passengers – FMCSA regulated when crossing jurisdiction

number, or rural route box number (no P O Boxes) along with

lines.

the city, state, and zip code of the location where the records

Household Goods – FMCSA regulated when crossing juris-

are maintained.

diction lines.

US DOT NUMBER: the number assigned to the Motor Carrier

MILEAGE INFORMATION

Responsible for Safety (MCRS) of the vehicle by the FMCSA.

(if applicable)

“X” COLUMNS: enter a “X” in box in front of each IRP juris-

diction for which you have actual miles.

TAXPAYER IDENTIFICATION NUMBER (TIN): the nine digit

FEIN or SSN of the registrant.

TOTAL FLEET MILES: add the mileage reported for each ju-

risdiction and enter the total in this space.

MAILING ADDRESS: The address to which any correspon-

dence may be mailed if different from the business address.

SIGNATURE/TITLE/DATE: original signature of the owner,

partner, corporate officer or person holding power of attorney

for the company.

The office mailing address is:

The office is located in the:

ALABAMA DEPARTMENT OF REVENUE

ALABAMA TAXPAYER SERVICE CENTER

MOTOR VEHICLE DIVISION

2545 TAYLOR ROAD

MOTOR CARRIER SERVICES UNIT

MONTGOMERY, AL 36117

P.O. BOX 327620

Telephone: (334) 242-9000

MONTGOMERY, AL 36132-7620

Fax: (334) 242-9073

Website:

Email: mcs@revenue.alabama.gov

Mv Irp-B - Mileage Schelude Template Page 2

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