Form MP-1 Quarterly and Annual Report Form Motor Carriers of Passe

The collection of this information is authorized under the provisions of 49 CFR 14123. Public reporting for this collection of information is estimated to be 1.5 hours per response, including the time for reviewing instructions and completing and reviewing the collection of
information. All responses to this collection of information are mandatory, and will be provided confidentiality to the extent allowed by the Freedom of Information Act (FOIA). Not withstanding 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 2126-0031. 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-MMI, U.S. Department of Transportation, Washington, D.C. 20590.

6. Revenue:
(a) Intercity regular route
(b) Charter or special
(c) Local or suburban
(d) Express and other revenue
(e) Total operating revenue
7. Total Operating Expenses
8. Net Operating Income (Loss)
9. Other Income (Deductions)
10. Extraordinary Items, Net of Taxes
11. Total Provision for Income Taxes
12. Net Income (Loss)
13. Total Assets
14. Total Liabilities
15. Shareholders’ Equity
16. Operating Ratio

Certification:
I certify that this form was prepared by me or under my supervision, that I have examined it,
and that the items reported on the basis of my knowledge and belief are correctly shown.
Your name (print or type)

Official title

Address
City, State, Zip

Telephone No. (including area code)

Signature

Date