Form Tc-852 - Irp Original (Schedule A) And Supplemental (Schedule C) Application Page 2
Download a blank fillable Form Tc-852 - Irp Original (Schedule A) And Supplemental (Schedule C) Application in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Tc-852 - Irp Original (Schedule A) And Supplemental (Schedule C) Application with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4Registrant account number
UT-
Fleet number
Equipment Information - continued
Action code
Make
FT Equipment number
Vehicle identification number
Type
Year
Fuel
For Office Use Only
Do not
renew
1 Yr. Pro. tax _______
Axles/Seats
Name of titled owner/lessor
Unladen weight
Decl. comb. gross
wgt
2 Yr. Pro. tax _______
HVUT verified _______
Situs of vehicle (physical location of vehicle if different than fleet
I/M # verified _________
City
County
State
Inspec # verified _________
ZIP code
Select plate type
LE Skier
LE Arches
Title verified ___________
Lease start date
Owned/Leased
Lease end date
Vehicle safety changed?
FEIN/EIN of carrier responsible for vehicle safety
US DOT number
Factory price ____________
Yes
No
Sales tax Y/N _______
Truck pull trailer?
Plate
Less than 10K/miles
Title
Temp.
License plate number
Purchase date
Purchase price
Curr. veh. value___________
Yes
No
Action code
Make
FT Equipment number
Vehicle identification number
Type
Year
Fuel
For Office Use Only
Do not
renew
1 Yr. Pro. tax _______
Axles/Seats
Name of titled owner/lessor
Decl. comb. gross
Unladen weight
2 Yr. Pro. tax _______
wgt
HVUT verified _______
Situs of vehicle (physical location of vehicle if different than fleet
I/M # verified _________
Inspec # verified _________
City
County
State
ZIP code
Select plate type
LE Skier
LE Arches
Title verified ___________
Lease start date
Owned/Leased
Lease end date
Vehicle safety changed?
FEIN/EIN of carrier responsible for vehicle safety
US DOT number
Factory price ____________
Yes
No
Sales tax Y/N _______
Truck pull trailer?
Less than 10K/miles
Plate
Temp.
License plate number
Purchase date
Purchase price
Title
Curr. veh. value___________
Yes
No
Action code
FT Equipment number
Vehicle identification number
Type
Make
Year
Fuel
For Office Use Only
Do not
renew
1 Yr. Pro. tax _______
Unladen weight
Axles/Seats
Name of titled owner/lessor
Decl. comb. gross
2 Yr. Pro. tax _______
wgt
HVUT verified _______
Situs of vehicle (physical location of vehicle if different than fleet
I/M # verified _________
Inspec # verified _________
City
County
State
ZIP code
Select plate type
LE Skier
LE Arches
Title verified ___________
Lease start date
Owned/Leased
Lease end date
FEIN/EIN of carrier responsible for vehicle safety
Vehicle safety changed?
US DOT number
Factory price ____________
Yes
No
Sales tax Y/N _______
Truck pull trailer?
Less than 10K/miles
Plate
Title
Temp.
License plate number
Purchase date
Purchase price
Curr. veh. value___________
Yes
No
Deletions The original cab card and license plate must be surrendered on all deleted units within 10 business days in order to transfer fee
Equipment number
Plate
Vehicle identification number
Equipment number
Plate
Vehicle identification number
Equipment number
Plate
Vehicle identification number
Plate
Equipment number
Vehicle identification number
Equipment number
Plate
Vehicle identification number
Equipment number
Plate
Vehicle identification number
The State has in effect a requirement that registrants of Commercial Motor Vehicles (CMV) declare their knowledge of the applicable Federal and State
CMV safety laws and regulations. For more information, contact Utah Department of Transportation (UDOT) at 801-965-4000 or go to their website
at
udot.utah.gov
.
My signature below acknowledges that I understand and will comply with the reporting, payment, record keeping, and license display requirements as
specified in the International Registration Plan. I understand that failure to comply with the provisions shall be grounds for revocation of my registrations
in all member jurisdictions. I have reviewed and verified all information for accuracy and all corrections have been made. Under penalty of law, I certify,
under the penalties of perjury, that the information herein is true, correct, and complete.
Signature of person completing application
Date signed
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Pg320w - Council Wider Opportunity Trip Status And Troop Financial Assisstance Application
Business
Related Categories
Parent category: Financial