Form Op-1 - Application For Motor Property Carrier And Broker Authority Page 11

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FORM OP-1 Revised 01/10/2017

OMB No.: 2126-0016 Expiration: 01/31/2020

Fee No.:

Docket No. MC:

FOR FMCSA USE ONLY

Filed:

CC Approval No.:

The collection of this information is authorized under the provisions of 49 CFR, Parts 390-399.

Public reporting for this collection of information is estimated to be 2 hours per response, including the time for reviewing the instructions and completing

and reviewing the data inserted on the form electronically. All responses to this collection of information are mandatory, and will be provided in confidence to

the extent allowed by law. Notwithstanding any other provision of law, no person is required to respond to nor shall a person be subject to a penalty for failure

to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current

valid OMB Control Number. The valid OMB Control Number for this information collection is 2126-0016. Send comments regarding this burden estimate or

any other aspect of this collection of information, including suggestions for reducing this burden, to: Information Collection Clearance Officer, Federal Motor

Carrier Safety Administration, MC-MBI, U.S. Department of Transportation, Washington, D.C. 20590.

United States Department of Transportation

Federal Motor Carrier Safety Administration

Application for Motor Property Carrier and Broker Authority

FORM OP-1

This application is for all businesses requesting Operating Authority as a motor carrier, broker, and/or U.S.-based enterprise

carrier of property or household goods.

Section

APPLICANT INFORMATION

1. DO YOU NOW HAVE AUTHORITY FROM OR AN APPLICATION

If yes, identify the MC/FF Number (or lead docket number):

Yes