Form M-233ic - Oversize/overweight Inquiry/change Form
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1FORM M-233IC
Indiana Department of Revenue
State Form 51481
Oversize/Overweight
(R7 / 3-13)
Inquiry/Change
Form
Section 1
Please check which type of transaction you are requesting.
Cancellation of a requested permit. If your request is received before we issue your permit, the request will be honored.
(generally a fee will be charged for the cancellation of a superload permit) (Complete Section 1)
Permit Inquiry (Complete Section 1)
Permit Change for a issued or requested permit (Complete Section 1 and 2)
Company Name
Contact Telephone Number
Permit Number (If Applicable)
Fax Number
Social Security Number (If Sole Proprietor)
Federal Identifi cation Number
Original Tractor Serial Number
Section 2
Permit change: Please make changes in the appropriate areas below.
A Permit can only be changed within 72 hours from the issue date, except for annual and 90 day premits which you are allowed only
one (1) tractor change before expiration.
Tractor: Enter new tractor Serial Number - $3 fee ______________________________________
(this change can only be made if original tractor is inoperable).
Make of Tractor ____________________________________
License Plate Number _______________________________
State Where Licensed _______________________________
Year of Tractor _____________________________________
Dimension & Weight: Enter new dimensions or weight - $3 fee ___________________________
(mobile homes cannot apply for this type of change).
Axle weight or spacing changes, please enter below.
Axle Weights:
1._____________
2.____________
3.___________
4.___________
5.____________
6._____________
7.____________
8.___________
9. ___________
10.___________
Axle Spacing:
1._____________
2.____________
3.___________
4.___________
5.____________
6._____________
7.____________
8.___________
9. ___________
10.___________
Routes: Enter new route - $3 fee _____________________________________________________________________
_______________________________________ (the beginning or the end of a route will not be changed).
Time Extension: Only one extension will be granted before a permit expires (extensions vary based upon the type of permit)
$6 fee.
No other provisions on the original permit can be changed.
Motor Carrier Service
OS/OW Permit Section
7811 Milhouse Road, Suite M
Indianapolis, IN 46241-9612
Phone: (317) 615-7320
Fax: (317) 615-7241
Under penalties of perjury, I declare I have examined the above information, and to the best of my knowledge and belief it
is true, correct and complete.
_____________________________________________________
_______________________________
Signature
Date
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