Dot Number Determination/disclosure
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DOT Number Determination/ Disclosure
You can use this form to determine if a vehicle needs a U.S. Department of Transportation (DOT) number to register.
If the vehicle is an auto transport, charter party carrier, excursion service carrier, solid waste collection truck, or is used to
transport household goods, a DOT number will be required by June 30, 2010. When completed, take or mail this form to
any vehicle licensing office with your vehicle renewal or title application. If you have questions, call (360) 902-3770, Option 5.
1. Vehicle
Is your vehicle designed to transport 16 or more passengers, including the driver? . . . . . . . . . . . . . . . . . .
Yes
No
Does your vehicle have a gross vehicle weight rating (GVWR) of 26,001 pounds or more? . . . . . . . . . . .
Yes
No
If your vehicle has a GVRW between 14,001 pounds and 26,000 pounds, do you tow a trailer
with a GVRW of 10,001 pounds or more? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Is your vehicle used to transport hazardous materials that require a DOT placard? . . . . . . . . . . . . . . . . . .
Yes
No
Is your vehicle used as a private school bus? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If you answered Yes to any of the above, you must provide a DOT number to register the vehicle. Complete sections 2 and 3.
If you answered No to all of the above, you are not required to have a DOT number. Complete sections 1 and 3.
Is your vehicle for personal use only? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If you answered Yes, then a DOT number is not required. Go to section 3.
2. Carrier
If operating under your own DOT number, you will be the Carrier Responsible for Safety (CRS). If you operate under a
lease agreement you will be operating under someone else’s DOT number and they will be the CRS.
I operate under my own DOT number.
My DOT number ____________________________
Federal taxpayer ID number __________________________
Go to section 3.
I operate under short-term lease agreements that expire in less than 30 days.
Registered owner DOT number _________________
Federal taxpayer ID number __________________________
Go to section 3.
I operate under a long-term lease agreement that will not expire in 30 days. Attach a copy of the lease agreement or
equivalent (see page 2).
Registered owner DOT number ________________
Federal taxpayer ID number __________________________
Lessor name __________________________________________________________________________________
Lessor DOT number _________________________
Lessor federal taxpayer ID number _____________________
Will your lease expire within the vehicle registration period? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Go to section 3.
3. Registered owner’s vehicle identification
Name or business name
Address
City
State
ZIP code
Vehicle Identification Number (VIN)
Year
Make
Model
GVWR
License plate
The Department of Licensing has a policy of providing equal access to its services.
If you need special accommodation, please call (360) 902-3600 or TTY (360) 664-8885.
TD-420-012 (N/7/09) Page 1 of 2
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