Download:
pdf |
pdfInstructions for Completing the Combined Motor Carrier
Identification Report and HM Permit Application (MCS-150B)
Topic
I.
II.
III.
IV.
V.
Page
Federal Motor Carrier Safety Administration (FMCSA) Overview .......................................................................................1
Filing Options ......................................................................................................................................................................1
Step-By-Step Instructions ...................................................................................................................................................2
Where Can I Get Additional Help And Information?..........................................................................................................10
Combined Motor Carrier Identification Report and HM Permit Application (MCS-150B)..................................................11
I. Federal Motor Carrier Safety Administration (FMCSA) Overview
The Federal Motor Carrier Safety Administration (FMCSA) registration process requires that companies define the type of
business operation (Motor Carrier, Broker, Shipper, Freight Forwarder and/or Cargo Tank Facility) that they plan to establish.
FMCSA’s responsibilities include monitoring and enforcing compliance with the Federal Motor Carrier Safety Regulations
(FMCSR) and the Hazardous Materials Regulations (HMR) governing both safety and financial responsibility. The Agency’s
focus on both concerns is reflected in the dual path of its current registration process. Companies may find that they are
subject to both registration requirements—USDOT Number (Forms MCS-150 and MCS-150B)—and Interstate
Operating Authority (Forms OP-1, OP-1(P), OP-1(FF), OP-1(MX), or OP-2).
FMCSA encourages all applicants with Internet access to use our online registration assistant
(http://www.fmcsa.dot.gov/online-registration) to determine all FMCSA registration requirements. For applicants without
Internet access, FMCSA can mail instructions, forms, and other materials designed to assist in the off-line registration process;
call FMCSA at 1-800-832-5660.
These instructions assume that the applicant has determined that a USDOT Number is required and that the MCS-150B form
must be submitted.
II. Filing Options
There are two options for filing the necessary forms to obtain a USDOT Number:
•
Completing and filing the required MCS-150B forms online, or
•
Completing a printed copy and mailing to the FMCSA
FMCSA strongly encourages applicants to use the electronic online application process since it has built-in edit
checks and simple yes-and-no questions for easy, accurate completion. It is also significantly faster than applying by
mail. The estimated time to complete the form online is approximately 20 minutes.
•
Option 1: Filing Online (recommended).
o We encourage you to print all related form instructions prior to completing the online forms.
o To complete and submit application form(s), go to: http://www.fmcsa.dot.gov/online-registration.
o Upon submission, a USDOT Number for the company is issued immediately, if the application is approved.
o FMCSA suggests that you record the USDOT Number that is assigned.
•
Option 2: Filing Paper by Mail.
o Submit all required MCS and/or OP forms together.
o Once the application is completed, FMCSA suggests making a copy for the company’s files.
o Mailed applications, on average, take four to six weeks processing time.
o Notification of USDOT Number will be sent to the mailing address provided in items 8-11 of submitted MCS150 or MCS-150B form.
o Mail completed application form(s) to:
Federal Motor Carrier Safety Administration
Attention: USDOT Number Application
1200 New Jersey Avenue SE
Washington, DC 20590
Note: Applications that are incomplete, unreadable, or unsigned will be rejected and returned via mail, delaying
the receipt of the company’s USDOT Number.
Instructions for form MCS-150B (Revision 6/12/2007)
Page 1 of 12
III. Step-By-Step Instructions
These instructions will assist in preparing a complete and accurate MCS-150B application. The instruction numbers below
correspond to the numbered items on the MCS-150B form. When completing the application, please print clearly in ink or type
all information.
Reason for Filing (Top of Form) — The information in the table below represents the valid reasons for filing the MCS-150B
Form. Select one of the four reasons and mark its corresponding box at the top of the form under “Reason for Filing,” and
complete all the items on the form that are mandatory for the selected reason.
If you would like to:
Obtain a USDOT Number – first time
filer
File the formal MCS-150B Biennial
Update, or update MCS-150B
information
Notify FMCSA that the company is no
longer operating as an interstate Motor
Carrier
Reapply after New Entrant Registration
has been revoked (USDOT Number
inactivated)
Select the following under
“Reason for Filing”:
NEW APPLICATION
BIENNIAL UPDATE OR CHANGES
OUT OF BUSINESS
NOTIFICATION
REAPPLICATION (AFTER
REVOCATION OF NEW
ENTRANT)
Complete the following form items:
All applicable items (1-30); exclude items
16 and 28.
All applicable items 1-16, 30, and any
others where information has changed
since the company’s last update.
All applicable items 1-16 and 30.
All applicable items (1-30). In item 16
enter the USDOT Number previously
assigned to the company.
NOTE: If the company was previously assigned a USDOT Number, do NOT submit this form to obtain a new USDOT
Number. That is, if the company currently has or has had at any time a USDOT Number, then the only valid reasons for
completing this form are: reapplication after revocation of a new entrant registration, out of business notification, or biennial
update or other interim change to the company’s MCS-150B application information.
See instructions labeled “To find out if a company already has a USDOT Number” in Section IV of this document.
1. Name of Motor Carrier — 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.
2. Trade or D.B.A. (Doing Business As) 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.
3-6. Principal Address — Enter the address where the company’s safety records are maintained. FMCSA will use this
address for on-site visits to Motor Carriers for the purpose of conducting safety audits, compliance reviews, and other
activities. For this reason, do not enter a P.O. Box as the Principal Address or processing of the company’s application will be
delayed.
7. Colonia (Mexico Only) — If the company’s principal address (and safety records location) is in Mexico, enter the “Colonia”
or “Barrio” in Mexico.
8-11. Mailing Address — Enter the mailing address where the company wants all its FMCSA correspondence to be sent (this
may be a P.O. Box). If all parts of this address are the same as the “Principal Address” (items 3-6) write “SAME” in item 8 and
leave items 9-11 blank. However, if any parts of the mailing and principal addresses differ, complete all items 8-11.
12. Colonia (Mexico Only) — If the company’s mailing address is in Mexico, enter the “Colonia” or “Barrio” in Mexico.
13. Principal Business Phone Number — Enter the primary telephone number, including area code, for the “Principal
Address” (items 3-6). (This may be a cell phone number.)
Instructions for form MCS-150B (Revision 6/12/2007)
Page 2 of 12
14. Principal Contact Cell Phone Number — Enter the cell phone number, if any, including area code. (If this is the same as
the “Principal Business Phone Number” [item 13], enter “Same.”)
15. Principal Business Fax Number — Enter the company’s fax number, including area code. This number is for the location
provided as “Principal Address” (items 3-6) above. If there is no fax number available leave this item blank.
16. USDOT NO. — If the company is not a new applicant, that is if it already has a USDOT Number, enter the company’s
USDOT Number.
17. MC OR MX NO. — If the company has already been assigned an “MC” or “MX” identification number for Interstate FMCSA
Operating Authority, enter the number. This includes MC or MX numbers that are pending.
18. Dun & Bradstreet NO. — If the company has a Dun & Bradstreet identifier number, enter it. If you do not know the
number, visit http://www.dnb.com, or call Dun & Bradstreet at 1-800-999-3867.
19. IRS/TAX ID NO. — Enter either the Employer Identification Number (EIN) assigned to the Motor Carrier company by the
Internal Revenue Service, or the owner’s Social Security Number (SSN).
20. Internet E-Mail Address — Enter the e-mail address, if the company has one, for the official point of contact.
21. Carrier Mileage — Enter the total mileage of all Commercial Motor Vehicles (CMV) in the company’s operation to the
nearest 10,000 miles for the last calendar year (e.g., 2006). If the company did not operate a CMV during the last calendar
year, leave this item blank.
22. Company Operation — The company operation type will tell FMCSA what type(s) of Motor Carrier or Hazardous
Materials Shipper operations the company plans to provide. If you select “Vehicle Registrant Only” you may not select any
other carrier or shipper operation. If you select only Hazmat Shipper (no carrier operation) from the list, the company is not
required to obtain a USDOT Number, so no filing is needed. Read the instructions and definitions below before responding.
These selections will determine if this business is regulated by the FMCSA.
NOTE: The Pipeline and Hazardous Materials Safety Administration (PHMSA) regulates Motor Carriers and Shippers of
hazardous materials. If the company will carry or ship hazardous materials it may need to be registered with PHMSA
(http://hazmat.dot.gov/regs/register/register.htm) in addition to FMCSA.
Select all that apply:
•
Interstate Carrier — The company is an Interstate Carrier if any part of its operation transports property or
passengers in support of interstate commerce, i.e., the property or passengers cross State lines either before the
company received them, while the company is transporting them, or after the company has transferred the property
or passengers. The transportation of the property or passengers may include transport by plane, train, or boat in
addition to the company’s commercial motor vehicle. For example: if the origination and destination indicated on the
bill of lading—when one exists—are not in the same State, then the shipment is interstate and the company needs to
be registered as an Interstate Carrier.
The company is also considered to be an Interstate Carrier if the property or passengers being transported will ever
do ANY of the following:
o Cross State lines (including a place outside the United States)
o Move from the United States or a U.S. territory to a foreign country, or vice versa
o Have origination and destination points within a State, but pass through another State or foreign country
during transport
•
Intrastate Hazmat Carrier — The company is an Intrastate Hazardous Materials Carrier if any part of its business
operation meets ALL of the following criteria:
o Transports Hazardous Materials in quantities that are regulated by the Department of Transportation (DOT)
o Never crosses State lines (including a place outside the United States)
o Never moves from the United States or U.S. territory to a foreign country, or vice versa
o Never passes through another State or foreign country during transport
The company is required to comply with FMCSA Safety Regulations and Hazardous Materials Regulations.
•
Intrastate Non-Hazmat Carrier — The company is an Intrastate Non-Hazardous Materials Carrier if its business
operation meets ALL of the following criteria:
o Does NOT transport Hazardous Materials in quantities that are regulated by DOT
o Never crosses State lines (including a place outside the United States)
o Never moves from the United States or U.S. territory to a foreign country, or vice versa
Instructions for form MCS-150B (Revision 6/12/2007)
Page 3 of 12
o
Never passes through another State or foreign country during transport
•
Interstate Hazmat Shipper — The company is an Interstate Hazardous Materials Shipper if any part of its business
operation offers, or makes Hazardous Materials available to a carrier for transportation in interstate or foreign
commerce. If the company makes the Hazardous Materials available AND also transports the Hazardous Materials,
then the company is considered to be both an Interstate Hazmat Shipper and an Interstate or Intrastate Motor Carrier.
Companies that are Hazmat Shippers only (don’t provide carrier transport) do not need a USDOT Number to operate
and therefore are not required to file this form. Interstate Hazmat Shippers must however, still comply with the
Hazardous Materials Regulations.
•
Intrastate Hazmat Shipper — The company is an Intrastate Hazardous Materials Shipper if it exclusively tenders or
makes Hazardous Materials available to an Intrastate Hazmat Carrier for actual transport. If the company offers or
makes available Hazardous Materials AND transports Hazardous Materials, then it is considered as both an
Intrastate Hazmat Shipper and an Interstate or Intrastate Motor Carrier (both options should be selected in response
to this item). If the company never operates as a carrier, but only operates as a Hazmat Shipper, it is not required to
obtain a USDOT Number and need not file this form. However, they will be required to comply with the Hazardous
Materials Regulations.
•
Vehicle Registrant Only — The company is a Vehicle Registrant Only if its base state of operations requires the
company/individual to obtain a USDOT Number as a required part of its state commercial vehicle registration process
AND the individual that is listed on the vehicle registration and to whom license plates are issued will never operate
the CMV under its own assigned USDOT Number or Operating Authority. Two of the more common reasons to
receive a USDOT Number with a “vehicle registrant only” status are illustrated in the examples below. If you select
“vehicle registrant only” as the response, do not select any other responses for item 22.
Examples:
o
o
The company owns and registers its commercial trucks for the sole purpose of renting or leasing those
trucks to Motor Carriers that will operate the trucks to transport goods.
The company is an owner-operator that will never operate the trucks under its own USDOT Number or
Operating Authority (the company only operates under another company’s USDOT Number or Operating
Authority).
NOTE: If the company is a Vehicle Registrant Only, do not select additional company operations. Skip to item 30,
sign, and date the form.
23. Operation Classification — Is based on the type of business the company is engaged in and will help determine the
FMCSA regulations the company is subject to. It will also determine if the company requires Interstate Operating Authority.
The company’s operations may place it under multiple operation classifications, so selections should be made carefully.
Definitions of Classifications:
A.
Authorized For-Hire — A non-exempt (exempt Motor Carriers are defined in B, below) Motor Carrier who receives
compensation for transporting passengers, FMCSA-regulated goods, or household goods that are owned by others.
NOTE: If you select “Authorized For-Hire Carrier” as one of the company’s operation classifications, the company
will also be required to obtain Interstate Operating Authority (MC or MX Number) by filing the appropriate OP form
with the FMCSA.
B.
Exempt For-Hire — A Carrier who receives compensation for transporting only exempt goods (commodities that are
NOT regulated by the FMCSA); or an Interstate Carrier transporting exclusively within a commercial zone that is
exempt from FMCSA operating authority rules. Carriers are also exempt if they only transport employees of their
company (e.g., a company shuttles its own employees to and from a work station). Exempt status typically excuses a
carrier from the Operating Authority requirement, but a USDOT Number is still required.
NOTE: Administrative Ruling No. 119 (http://www.fmcsa.dot.gov/adminrule119) provides additional guidance for
identifying EXEMPT commodities (those NOT regulated by the FMCSA). If all the commodities that the company
transports appear on this list, then the commodities are considered exempt. Information about commercial zone
exemptions may be found at 49 CFR 372 (http://www.fmcsa.dot.gov/49CFR-372).
C. Private Property — A company that transports its own cargo, usually as a part of a business that produces, uses,
sells, and/or buys the cargo that is being hauled.
Instructions for form MCS-150B (Revision 6/12/2007)
Page 4 of 12
D. Private Passengers (Business) — A “for-profit” company that provides interstate transportation of passengers in
order to support its primary line of business. The passenger transportation service should not be available to the
general public. For example, a hotel chain that provides a free shuttle service that crosses a state line driving from an
airport to a hotel is classified as “Private Passengers (Business).” The shuttle service furthers the business, but is not
a source of income.
Refer to regulation 49 CFR 390.5 (http://www.fmcsa.dot.gov/49CFR-390.5) for more information on Private
Passenger classifications.
E.
Private Passengers (Non-business) — A “not-for-profit” company that provides interstate transportation of
passengers in order to support its primary line of business. The passenger transportation service that is offered
should not be available to the general public. For example, a not-for-profit youth center that uses a bus to transport
youth on field trips is a Private Passenger (Non-business). Refer to regulation 49 CFR 390.5
(http://www.fmcsa.dot.gov/49CFR-390.5) for more information on Private Passenger classifications.
F.
Migrant — Interstate transportation provided by a Contract Carrier, but not a Common Carrier, of three or more
migrant workers to or from their employment using any motor vehicle other than a passenger automobile or station
wagon. A Contract Carrier provides transport service to one or more companies on a contract basis. Contract carriers
do not maintain a regularly scheduled service. A Common Carrier transports persons or property for pay to anyone at
any time and to any place within its operating authority.
G. U.S. Mail — Transportation of U.S. mail under contract with the U.S. Postal Service.
H.
Federal Government — Transportation of property or passengers by a U.S. Federal Government Agency.
I.
State Government — Transportation of property or passengers by a U.S. State Government Agency.
J.
Local Government — Transportation of property or passengers by a local municipality.
K.
Indian Tribe — Transportation of property or passengers by an Indian tribal government.
L.
Other — Transportation of property or passengers by an operation classification not described above.
NOTE: If the carrier’s vehicles are sometimes leased to another motor carrier, select the appropriate options (A-K)
indicating all types of operations performed.
24. Cargo Classifications — Refers to the types of materials the company transports or ships (offers for transport). The
company may transport/ship materials from multiple categories. Select all the letters corresponding to the types of cargo the
company transports/ships. If "Other" is selected, enter the name of the commodity in the space provided.
NOTE: If you indicate that the company transports passengers, it means that the company uses a motor coach, school bus,
mini-bus, van, or limousine to transport passengers. Do not select this item if someone rides along to assist the driver when
the company’s primary business is to transport property. If you check this option, you will also have to indicate the number
of each type of passenger vehicle that is owned or leased under the motor coach, school bus, mini-bus, van, or limousine
headings provided in item 26 of this form.
25. Hazardous Materials (Carrier or Shipper) — Complete this item only if the company transports or ships (offers for
transport) Hazardous Materials. Otherwise, proceed to item 26.
•
•
The letters “C” and “S” in the columns refer to “Carrier” and “Shipper.” Select “C” or “S” next to the Hazardous
Materials that the company carries or ships. If the company is both a Carrier and a Shipper of the Hazardous
Materials, select both “C” and “S.”
The letters “B” and “NB” refer to “Bulk” and “Non-bulk.” Select “B” next to the appropriate Hazardous Materials if the
company transports/ships greater than 119 gallons of it. If the company transports/ships 119 gallons or less of the
Hazardous Materials, select “NB.”
Instructions for form MCS-150B (Revision 6/12/2007)
Page 5 of 12
The Hazardous Materials Classes and Divisions listed below correspond to those listed in 49 CFR 173.2. (Short descriptions
are provided. For more information see the Hazardous Materials guide at http://www.fmcsa.dot.gov/hm-comply.)
Instructions for form MCS-150B (Revision 6/12/2007)
Page 6 of 12
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
M.
N.
O.
P.
Q.
R.
S.
T.
U.
V.
W.
X.
Y.
Div 1.1 Explosives (with mass explosion hazard)
Div 1.2 Explosives (with projection hazard)
Div 1.3 Explosives (with predominantly fire hazard)
Div 1.4 Explosives (with no significant blast hazard)
Div 1.5 Explosives (Very insensitive explosives;
blasting agents)
Div 1.6 Explosives (Extremely insensitive detonating
substances)
Div 2.1 Flammable Gas
Div 2.1 LPG (Liquefied Petroleum Gas)
Div 2.1 Methane Gas
Div 2.2 Non-Flammable Compressed Gas
Div 2.2 D (Anhydrous Ammonia)
Div 2.3 A (Poison Gas which is Poison Inhalation
Hazard (PIH) Zone A)
Div 2.3 B (Poison Gas which is PIH Zone B)
DIV 2.3 C (Poison Gas which is PIH Zone C)
DIV 2.3 D (Poison Gas which is PIH Zone D)
Class 3 Flammable and Combustible Liquid
Class 3 A (Flammable Liquid which is a PIH Zone A)
Class 3 B (Flammable Liquid which is a PIH Zone B)
Combustible Liquid (Refer to 49 CFR 173.20 (b))
Div 4.1 Flammable Solid
Div 4.2 Spontaneously Combustible Material
Div 4.3 Dangerous When Wet Material
Div 5.1 Oxidizer
Div 5.2 Organic Peroxide
Div 6.2 Infectious Substance (Etiologic agent)
Z. Div 6.1 A (Poison Liquid which is a PIH Zone A)
AA. Div 6.1 B (Poison Liquid which is a PIH Zone B)
BB. Div 6.1 Poison (Poisonous Liquid with no inhalation
hazard)
CC. Div 6.1 Solid (Meets the definition of a poisonous
solid)
DD. Class 7 Radioactive Materials
EE. HRCQ (Highway Route Controlled Quantity of
Radioactive Material)
FF. Class 8 Corrosive Material
GG. Class 8 A (Corrosive Liquid which is a PIH Zone A)
HH. Class 8 B (Corrosive Liquid which is a PIH Zone B)
II. Class 9 Miscellaneous Hazardous Materials (See
http://www.fmcsa.dot.gov/hm-comply for more
details)
JJ. Elevated Temperature Material (Meets definition in
49 CFR 171.8 for an elevated temperature material)
KK. Infectious Waste (Meets definition in 49 CFR 171.8
for an infectious waste)
LL. Marine Pollutants (Meets Definition in 49 CFR 171.8
for a marine pollutant)
MM. Hazardous Sub (RQ) (Meets definition in 49 CFR
171.8 of a reportable quantity of a hazardous
substance)
NN. Hazardous Waste (Meets definition in 49 CFR 171.8
of a hazardous waste)
OO. ORM (Meets definition in 49 CFR 171.8 of Other
Regulated Material)
NOTE: Information on Poison Inhalation Hazards is found in column 7 of the Hazardous Materials table (49 CFR 172.101).
Specific Hazardous Materials information can be obtained by accessing the Hazmat Table at
http://www.fmcsa.dot.gov/hm-comply.
26. Number of Vehicles That Will Be Operated In The U.S. — Provide the number of each type of CMV that the company
uses in its U.S. operations broken out by the method used to acquire the vehicle (owned, term-leased or trip-leased). Owned
means the company holds title to the CMV, term leased means the vehicle is leased for a specific time period or term of
contract, and trip leased means the CMV is leased on a trip-by-trip basis as needed. If the company owns or leases a
commercial motor vehicle that is used to transport passengers rather than property within the U.S. (includes motorcoach,
school bus, mini-bus, passenger van, or limousines only), then indicate the number of each type of passenger-carrying CMV
(by its passenger-carrying capacity) that is owned, term-leased or trip-leased. For passenger-carrying vehicles, count the
driver as a passenger when determining a vehicle’s passenger-carrying capacity. Reference the definitions for each type of
passenger-carrying vehicle below. For example, if the company owns 3 straight trucks and 1 trailer and term leases 2
additional trailers, the table would be filled out like this:
Hazmat
Cargo
Straight Truck
Trailers
Trucks Tractors
Tank
Trucks
Hazmat
Cargo
Tank
Trailers
Number of vehicles carrying number of passengers
(including the driver)
Motorcoach School Bus
1-8
Owned
Term
Leased
Trip
Leased
3
9-15 16+
Minibus
16+
Passenger
Van
1-8
9-15
Limousine
1-8
9-15
1
2
Instructions for form MCS-150B (Revision 6/12/2007)
Page 7 of 12
16+
If the company transports passengers and has a term lease on 2 limos that carry 9 passengers each (including the driver) and
owns 1 mini-bus that carries 18 passengers (including the driver), the table would be filled out like this:
Hazmat
Cargo
Straight Truck
Trailers
Trucks Tractors
Tank
Trucks
Hazmat
Cargo
Tank
Trailers
Number of vehicles carrying number of passengers
(including the driver)
Motorcoach School Bus
1-8
9-15 16+
Minibus
16+
Passenger
Van
1-8
9-15
Limousine
1-8
9-15
1
Owned
Term
Leased
Trip
Leased
2
Passenger vehicles are defined as:
•
Motor Coach — A vehicle designed for long distance transportation of passengers, usually equipped with storage
racks above the seats and a baggage hold beneath the passenger compartment.
•
School Bus — A vehicle designed and/or equipped mainly to carry primary and secondary students to and from
school, usually built on a medium or large truck chassis.
•
Mini-bus — A motor vehicle designed or used to transport 16 or more passengers, including the driver, and typically
built on a small truck chassis; has a smaller seating capacity than a motor-coach.
•
Passenger Van — A small motor vehicle designed or used to transport 15 or fewer passengers, including the driver
(If the company uses a van to transport something other than passengers, enter the number of vehicles under
“straight trucks.”)
•
Limousine — A passenger vehicle usually built on a lengthened automobile chassis.
27. Driver Information — Enter the number of interstate and intrastate drivers who operate CMVs for the company on an
average workday. Part-time, casual, term-leased, trip-leased, and company drivers should be included in the company’s total
driver headcount. Also, enter the total number of drivers (regardless of employment status) used in the company’s operations
(interstate and intrastate) and the total number of drivers that hold a valid Commercial Driver’s License (CDL). Also, see the
“100-mile-radius driver” consideration below
NOTE: The total number of drivers should be equal to all interstate plus all intrastate drivers. The total number of CDL
drivers should be equal to or less than the total number of drivers.
100-mile-radius driver — Driver operates exclusively within a 100 air-mile radius of the normal work-reporting location.
For example, the company has 10 drivers, 5 that operate in interstate commerce and 5 that operate in intrastate
commerce. Of the 5 that are intrastate, 2 stay exclusively within the 100-mile radius of their work location and 3 go beyond
the 100-mile radius. All of the 5 interstate drivers are operating beyond a 100-mile radius. Of the 10 drivers, 8 have their
CDL. This is how the form would be completed:
DRIVER INFORMATION
INTERSTATE
Within 100-Mile Radius
Beyond 100-Mile Radius
INTRASTATE
2
5
3
TOTAL DRIVERS
TOTAL CDL
DRIVERS
10
8
28. If the company’s USDOT Number and registration are currently revoked by FMCSA — Enter the company’s assigned
USDOT Number in the space provided.
29. Enter name(s) of sole proprietor(s), officers, or partners and their titles — If the company’s legal business structure is
“Sole Proprietor,” then enter the owner’s name and title in the spaces provided; otherwise, enter the name of two company
partners (if the company is a partnership) or two corporate officers and their titles if the company is a corporation (for example,
corporate officers might include Vice President , Secretary, Treasurer, President).
30. Check Hazardous Materials Transported — Check each of the boxes that represent a type of Hazardous Material (HM)
that the company transports. NOTE: If the company doesn’t transport any of these HM substances, then they do not need to
apply for a Hazardous Materials (HM) Safety Permit. If the company still needs to obtain a USDOT Number to operate as a
carrier in interstate commerce, then it should complete the MCS-150 Form, Motor Carrier Identification Report, instead of the
MCS-150B Form.
31. New or Renewal Permit — Mark the “initial” button if the company currently DOES NOT have an HM Safety Permit and
you are filing this form to obtain one. If the company currently holds an HM Safety Permit and would like to renew it, then mark
the “renewal” button.
Instructions for form MCS-150B (Revision 6/12/2007)
Page 8 of 12
16+
32. Number of Accidents Within the Last Year — If the company currently does not have a Federal USDOT Number, then
enter the number of accidents that the company has had in the last 365 days. The definition of “accident” as defined in 49 CFR
390.5 is:
(1) An occurrence involving a commercial motor vehicle operating on a highway in interstate or intrastate commerce
which results in (except as provided in paragraph 2 of this definition):
(i)
A fatality;
(ii)
Bodily injury to a person who, as a result of the injury, immediately receives medical treatment away
from the scene of the accident; or
(iii)
One or more motor vehicles incurring disabling damage as a result of the accident, requiring the motor
vehicle(s) to be transported away from the scene by a tow truck or other motor vehicle.
(2) The term accident does not include:
(i)
An occurrence involving only boarding and alighting from a stationary motor vehicle; or
(ii)
An occurrence involving only the loading or unloading of cargo.
33. Security Program Certification — Certify that the company has a satisfactory security program in place as required in
49 CFR Part 385 (http://www.fmcsa.dot.gov/49CFR-385), Subpart E by marking the “Yes” button. If you cannot certify that the
company has a satisfactory security program in place as required by 49 CFR Part 385, Subpart E, then mark the “No” button.
34. State Permit(s) Required — If the company is required to have a State permit to transport any of the materials listed in
item 30, mark the “Yes” button. If the company is not required to obtain a State permit to transport any of the materials listed in
item 30, mark the “No” button.
35. State Permit(s) Held — If you marked the “Yes” button in Item 34, then indicate, by checking the box next to its State
abbreviation, the State(s) for which the company currently has a State permit for transporting any of the HM substances listed
in item 30.
36. Certification Statement — Print or type the name of the individual authorized to sign documents on behalf of the entity
listed in item 1 (Name of Motor Carrier). This individual must sign, date, and print or type his/her name and title in the spaces
provided. The individual’s signature must match his/her name. The authorized signer in this item should match one of the
names provided in response to item 29.
NOTE: If this form is not signed and dated with a printed/typed name and title of an authorized individual, the application will
be rejected and a USDOT Number will NOT be assigned.
Instructions for form MCS-150B (Revision 6/12/2007)
Page 9 of 12
IV. Where Can I Get Additional Help And Information?
For your convenience, the following is a list of helpful links, most of which are referenced in this instructions document.
Information is provided in English-only unless otherwise specified.
1.
FMCSA Registration & Assistance Web page
http://www.fmcsa.dot.gov/online-registration
2.
Printable Registration Forms
http://www.fmcsa.dot.gov/r-l-forms
3.
To find out If a company already has a USDOT Number:
Call FMCSA toll-free at 1-800-832-5660 or go to http://www.fmcsa.dot.gov:
a. Under the section “Safety & Security” select “Company Safety Snapshot (SAFER)”
b. Select the option labeled “Name” and enter either the company’s “D.B.A. Name” (Doing Business As Name)
or its Legal Name.
c. Click on the “Search” button.
d. The system will inform you whether a USDOT Number is assigned to the name entered
4.
Mexico-based carriers should use this site to determine which forms are required to operate in the U.S.
http://www.fmcsa.dot.gov/new-entrant (English)
http://www.fmcsa.dot.gov/espanol/new_entrant_sp_index.htm (Spanish)
5.
Hazardous Materials Table/Hazardous Materials section of the FMCSA Web site
http://www.fmcsa.dot.gov/hm-comply
6.
Pipeline and Hazardous Materials Safety Administration (PHMSA) registration
http://hazmat.dot.gov/regs/register/register.htm
7.
To get a Dun & Bradstreet number or find out if a company already has one
http://www.dnb.com
8.
To determine if the company’s commodities are exempt (Administrative ruling 119). If any commodity the company
is transporting does not appear on these lists as exempt, then it is regulated.
http://www.fmcsa.dot.gov/adminrule119
9.
49 CFR 390.5 “Definitions” for more information on Private Passenger (Business) and Private Passenger (Nonbusiness)
http://www.fmcsa.dot.gov/49CFR-390.5
Instructions for form MCS-150B (Revision 6/12/2007)
Page 10 of 12
OMB No. 2126-0013 Expiration Date: 03/31/2011
A federal agency may not conduct or sponsor, and a person is not 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 OMB Control Number for this information collection is 2126-0013. Public reporting for this collection of information is estimated to be approximately 26 minutes
per response, including the time for reviewing instructions, gathering the data needed, 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). 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-RRA, 1200 New Jersey Avenue, SE, Washington, D.C. 20590.
U.S. Department of Transportation
U.S.
Department
of Transportation
Federal
Motor Carrier
Federal
Motor Carrier
Safety Administration
Safety Administration
Combined Motor Carrier Identifcation Report and HM Permit Application
Combined
Motor Carrier Identifcation Report and HM Permit Application
REASON FOR FILING (Mark only one)
NEW APPLICATION
BIENNIAL UPDATE OR CHANGES
OUT OF BUSINESS NOTIFICATION
1. NAME OF MOTOR CARRIER
REAPPLICATION (AFTER REVOCATION OF NEW ENTRANT)
2. TRADE OR D.B.A. (DOING BUSINESS AS) NAME
3. PRINCIPAL ADDRESS
4. CITY
5. STATE/PROVINCE
8. MAILING ADDRESS
9. CITY
10. STATE/PROVINCE
13. PRINCIPAL BUSINESS PHONE NUMBER
7. COLONIA (MEXICO ONLY)
11. ZIP CODE+4
14. PRINCIPAL CONTACT CELL PHONE NUMBER
17. MC OR MX NO.
16. USDOT NO.
6. ZIP CODE+4
12. COLONIA (MEXICO ONLY)
15. PRINCIPAL BUSINESS FAX NUMBER
18. DUN & BRADSTREET NO. 19. IRS/TAX ID NO.
EIN
SSN
21. CARRIER MILEAGE (to nearest 10,000 miles for last calender year) YEAR
20. INTERNET E-MAIL ADDRESS
22. COMPANY OPERATION (Mark all that apply)
A.
B.
Interstate Carrier
C.
Intrastate Hazmat Carrier
23. OPERATION CLASSIFICATION (Mark all that apply)
A.
Authorized For-Hire
D.
B.
Exempt For-Hire
E.
C.
Private Property
F.
Intrastate Non-Hazmat Carrier
D.
Interstate Hazmat Shipper
G.
H.
I.
Private Passengers (Business)
Private Passengers (Non-Business)
Migrant
E.
Intrastate Hazmat Shipper
U. S. Mail
Federal Government
State Government
J.
K.
L.
F.
Vehicle Registrant Only
Local Government
Indian Tribe
Other
24. CARGO CLASSIFICATIONS (Mark all that apply)
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
GENERAL FREIGHT
HOUSEHOLD GOODS
METAL:SHEETS, COILS, ROLLS
MOTOR VEHICLES
DRIVE AWAY/TOWAWAY
LOGS, POLES, BEAMS, LUMBER
25. HAZARDOUS MATERIALS (CARRIER OR SHIPPER) (Mark all that apply)
C
S
M.
N.
O.
P.
Q.
R.
BUILDING MATERIALS
MOBILE HOMES
MACHINERY, LARGE OBJECTS
FRESH PRODUCE
LIQUIDS/GASES
INTERMODAL CONT.
(C) CARRIER
B NB
C
S
S.
T.
U.
V.
W.
X.
PASSENGERS
OIL FIELD EQUIPMENT
LIVESTOCK
GRAIN, FEED, HAY
COAL/COKE
MEAT
(S) SHIPPER
GARBAGE, REFUSE, TRASH
U.S.MAIL
CHEMICALS
COMMODITIES DRY BULK
REFRIGERATED FOOD
BEVERAGES
(B) BULK – IN CARGO TANKS
B NB
C
S
Y.
Z.
AA.
BB.
CC.
DD.
PAPER PRODUCT
UTILITY
FARM SUPPLIES
CONSTRUCTION
WATER WELL
OTHER
(NB) NON-BULK – IN PACKAGES
B NB
EE.
HRCQ
FF.
CLASS 8
A.
DIV 1.1
K.
DIV 2.2D (Ammonia)
U.
DIV 4.2
B.
DIV 1.2
L.
DIV 2.3A
V.
DIV 4.3
C.
DIV 1.3
M.
DIV 2.3B
W.
DIV 5.1
D.
DIV 1.4
N.
DIV 2.3C
X.
DIV 5.2
E.
DIV 1.5
O.
DIV 2.3D
Y.
DIV 6.2
F.
DIV 1.6
P.
Class 3
Z.
DIV 6.1A
G.
KK.
INFECTIOUS WASTE
DIV 2.1 (Flam. Gas)
Q.
Class 3A
AA.
DIV 6.1B
H.
LL.
MARINE POLLUTANTS
DIV 2.1 LPG
R.
Class 3B
BB.
DIV 6.1 POISON
MM. HAZARDOUS SUB (RQ)
I.
DIV 2.1 (Methane)
S.
COMB LIQ
CC.
DIV 6.1 SOLID
NN. HAZARDOUS WASTE
J.
DIV 2.2
DD.
CLASS 7
OO. ORM
T. DIV 4.1
.
26. NUMBER OF VEHICLES THAT WILL BE OPERATED IN THE U.S.
C
S
B NB
GG. CLASS 8A
HH. CLASS 8B
II.
JJ.
CLASS 9
ELEVATED TEMP MAT.
Number of vehicles carrying number of passengers (including the driver)
Straight
Trucks
Truck
Tractors
OWNED
TERM LEASED
TRIP LEASED
27. DRIVER INFORMATION
Trailers
Hazmat Cargo
Tank Trucks
INTERSTATE
Motorcoach
Hazmat Cargo
Tank Trailers
Mini-bus
School Bus
1-8
9-15
INTRASTATE
16+
16+
Passenger
Van
1-8
9-15
TOTAL DRIVERS
Beyond 100-Mile Radius
Yes
If Yes, enter your USDOT Number. ____________________________________________________________
29. PLEASE ENTER NAME(S) OF SOLE PROPRIETOR(S), OFFICERS OR PARTNERS AND TITLES (e.g. president, treasurer, general partner, limited partner)
1.
Form MCS-150B (Revised: 6/12/2007)
2.
1-8
9-15
TOTAL CDL DRIVERS
Within 100-Mile Radius
28. IS YOUR USDOT NUMBER REGISTRATION CURRENTLY REVOKED BY THE FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION?
Limousine
No
16+
OMB No. 2126-0013 Expiration Date: 03/31/2011
30. WHICH OF THE FOLLOWING HAZARDOUS MATERIAL(S) DOES YOUR COMPANY TRANSPORT, CHECK ALL THAT APPLY:
Highway Route Controlled Quantities (HRCQ) of Radioactive materials.
More than 25 kg (55 pounds) of a Division 1.1, 1.2, or 1.3 material or a quantity of Division 1.5 material that requires placarding
For materials that meet the definition of “material poisonous by inhalation” (TIH) as defined in 49 CFR 171.8: More than 1 liter (1.08 quarts) per package of a material
meeting the definition of a Hazard Zone A TIH material, a material meeting the definition of a Hazard Zone B TIH material in a bulk package (capacity greater than 450
liters [119 gallons]), or a material meeting the definition of a Hazard Zone C or D TIH material in a bulk packaging that has a capacity greater than 13,248 L (3,500 gallons).
Shipments of compressed or refrigerated liquid methane or liquefied natural gas with a methane content of at least 85% in a bulk packaging that has a capacity greater
than 13,248 L (3,500 gallons)
INITIAL
31. IF YOU CHECK QUESTION 30, ARE YOU APPLYING FOR OR RENEWING A HM SAFETY PERMIT? PLEASE CHECK ONE:
RENEWAL
32. IF YOUR COMPANY DOES NOT HAVE A U.S. DOT NUMBER, HOW MANY ACCIDENTS AS DEFINED IN 49 CFR 390.5 HAS YOUR COMPANY HAD
IN THE PAST 365 DAYS?
33. DOES YOUR COMPANY CERTIFY THEY HAVE A SATISFACTORY SECURITY PROGRAM IN PLACE AS REQUIRED IN 49 CFR PART
385, SUBPART E?
Yes
No
34. IS YOUR COMPANY REQUIRED BY ANY STATE(S) TO HAVE A PERMIT FOR ANY OF THE HAZARDOUS MATERIALS LISTED
IN QUESTION 30?
Yes
No
35. IF YOUR ANSWER TO QUESTION 34 IS YES, CHECK THE STATE(S) IN WHICH YOU HAVE THE PERMIT.
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
SC
SD
TN
NV
NY
OH
OK
OR
PA
PR
RI
TX
UT
VT
VA
WA
WV
WI
WY
NOTE:
All motor carriers must comply with all pertinent Federal, State, local and tribal statutory and regulatory requirements when operating within the United States. Such requirements
include, but are not limited to, all applicable statutory and regulatory requirements administered by the U.S. Department of Labor, or by a State agency operating a plan pursuant to
Section 18 of the Occupational Safety and Health Act of 1970 (“OSHA State plan agency”). Such requirements also include all applicable statutory and regulatory environmental
standards and requirements administered by the U.S. Environmental Protection Agency or a State, local or tribal environmental protection agency. Compliance with these statutory and
regulatory requirements may require motor carriers and/or individual operators to produce documents for review and inspection for the purpose of determining compliance with such
statutes and regulations.
36. CERTIFICATION STATEMENT (TO BE COMPLETED BY AN AUTHORIZED OFFICIAL)
I, ____________________________________, certify that I am familiar with the Federal Motor Carrier Safety Regulations and/or the Federal Hazardous Materials Regulations. Under
penalties of perjury, I declare that the information entered on this report is, to the best of my knowledge and belief, true, correct, and
(Please print Name)
complete.
Signature
____________________________________
Form MCS-150B (Revised: 6/12/2007)
Date _________________________________
Title ____________________________________________
.
File Type | application/pdf |
File Title | Instructions for Completing the Motor Carrier Identification Report, Application for USDOT Number (MCS-150) |
Author | Bernd M. Constant |
File Modified | 2009-04-23 |
File Created | 2007-06-12 |