International Fuel Tax Agreement (Ifta) New Carrier Application

21. Select one of the following that reflects your principal usage of

22. List the number of each type of equipment in which you use motor

motor fuel in Montana:

fuel in Montana:

Drilling

Semi Tractors

Trucking

Trucks – 1 Ton or More

Farming

Seismograph

Construction – Public Road

Logging

Pickup Trucks, Cars

Construction – Other

Busing

Buses

Mining

Other

Other:

INSTRUCTIONS FOR COMPLETING IFTA APPLICATION

Effective Date: Enter the date you would like your license effective by. Current date or future date.

1. Business Federal ID Number: Enter your federal identification number. If the business is a sole proprietorship

with no employees and is not required to have a federal ID number, the owner’s Social Security Number must be

entered.

NOTE: When changing FEIN numbers and ownership a new license is required. This is the carrier’s

responsibility to notify the department.

2. US DOT Number: Enter your US DOT number. If you don’t have a US DOT number please contact (202)

366-9805 or visit

3. Legal name: This is the legal name of the business entity that owns/controls the Motor Carrier operation. The

name entered here should be the full legal business name (the name on the incorporation certificate, partnership

agreement, tax records, etc.). For example, if the company is a: • Sole Proprietorship/Individual, enter the legal

name, e.g., John A. Doe • Partnership, enter the legal names of all partners, e.g., John A. Doe and Jane B. Smith

• Corporation, enter the name on the incorporation certificate (this name must include the type of corporation),

e.g., John Doe INC, John Doe LLC.

and/or Trade name: Enter the company’s trade name if it is different from the company’s official business

name (the name entered in item 1). For example, if you entered “John A. Doe” in item 1 as the company’s

official business name, but the trade name, or “Doing Business As” name, is “John’s Trucking Company,” you

would enter “John’s Trucking Company” in this item

4-6.

Mailing Address: This must be your complete mailing address. All forms, licenses and correspondence will be

sent to this address.

7-9.

Location Address: Fill in this address only if your physical address is different than your mailing address.

10. Business Phone Number: Telephone number of the person that can be reached concerning information about

your license and reports.

11. Fax Number: Fax number of the person that can be reached concerning information about your license and

reports.

12. Email Address: Email address of the person that can be reached concerning information about your license and

reports.

13. “X” Type of Organization: Indicate which type of ownership best describes your business.

14-15. Identify Owner, Partners or Corporate Officers: Identify owner if individual ownership, Partners if a

partnership, or officers if a corporation. Include social security number(s), name, address, and telephone number

of each person listed.

16. Do You Maintain Bulk Storage in Montana: Indicate whether or not you have tax-free bulk fuel storage

available to you in Montana.

17. Other States Where Bulk Fuel is Maintained: List all states where you have tax-free bulk fuel storage.

18. Have you ever been licensed in another jurisdiction? Has your IFTA license ever been revoked? Indicate

whether you have ever been licensed in another jurisdiction. Indicate whether your IFTA license is or has ever

been revoked.

19. The Jurisdictions in Which You Operate: Mark an “X” next to each jurisdiction in which you intend to operate

your vehicle(s). Mark the ALL block if you will be operating in all the jurisdictions listed.

20. Number of Vehicles Requiring IFTA Decals: Indicate number of IFTA qualified vehicles requiring decals.

You will be sent 2 decals per vehicle. Payment of $2.00 per set of decals must accompany your application.

21. Select One of the Following That Best Reflects Your Principal Usage of Diesel Fuel in Montana: Check the

box that best describes your principal use of diesel fuel.

22. List the Number of Each Type of Equipment in Which You Use Diesel Fuel in Montana: Indicate the

number of each type of diesel-powered vehicle that you have on the list.

AUTHORIZED SIGNATURE AND DATE MUST BE COMPLETED IN ORDER TO PROCESS THE APPLICATION.

By cooperative agreement, the Montana Department of Transportation exchanges information with other tax collecting agencies.

Alternative accessible formats of this document will be provided upon request.

International Fuel Tax Agreement (Ifta) New Carrier Application - 2014 Page 2

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