Annual Gross Revenue Return Form And Statement Of Assessment Due - Office Of Public Carrier Regulations Of Delaware Department Of Transportation Page 5

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This form is designed to capture pertinent information regarding the qualified Public Carrier vehicles, which will be
in operation for your business. Please complete this form and mail back to our office in the return envelope or fax it
to our office at (302) 739-6299.
COMPANY EQUIPMENT SCHEDULE
VEHICLES IN SERVICE AS OF DECEMBER 31, 2006
Vehicle Identification Number
Make/Model
Number of
Date Added to
Date Deleted
(VIN)
Passengers
Fleet
From Fleet
Carried
*****ALONG WITH THE ABOVE VEHICLE LIST PLEASE ATTATCH A CURRENT
DRIVERS LIST FOR YOUR COMPANY*****

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