Form P-Complaint - Complaint Involving Intrastate Motor Carrier Operations (Page 3 of 3) in pdf

Form P-Complaint - Complaint Involving Intrastate Motor Carrier Operations Page 3

Section 5: CARRIER CONDUCTING MOVES WITHOUT OPERATING AUTHORITY (Haul for Hire Violations)

1. Was/are the movement(s) conducted from one location in Michigan to another location in Michigan?

– The move(s) you wish to file a complaint about was interstate in nature. The MPSC has jurisdiction

only on those moves made completely within Michigan (intrastate). Please contact the Federal Motor Carrier

Safety Administration (FMCSA), which has jurisdiction over interstate moves:

Telephone: 1-888-DOT-SAFT (1-888-368-7238)

No further completion of this form is required.

–

_____

Move from: ________________________________________________, __________________________

Street address

City

to: ________________________________________________, __________________________

Street address

City

Are movements being made on an ongoing basis?

–

What is your source of information (how do you know these moves are being made)? _________________

______________________________________________________________________________________

Do you have any documents to substantiate your claim (i.e., bills of lading, billing statement, etc.)?

2. Please proceed to Section 6 to enter a detailed statement of your complaint.

Section 6: DETAILED STATEMENT OF COMPLAINT

Please provide a detailed statement of your complaint. Include any details, including dates, names and contact

telephone numbers of involved persons who may have additional information, and agencies, which may assist in

the investigation of your complaint. When complete, please proceed to Section 7 and enter your signature and date

of completion.

Section 7: SIGNATURE AND SUBMISSION

Completed by: ________________________________ on __________________________________

For further assistance, please contact the Motor Carrier Division at (517)284-8120.

Submit this completed form and any supporting attachments to:

Michigan Department Licensing and Regulatory Affairs

Michigan Public Service Commission

Motor Carrier Division

P.O. Box 30221

Lansing, Michigan 48911

Form P-Complaint - Complaint Involving Intrastate Motor Carrier Operations Page 3