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

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 2126-0031. Public reporting for this collection of information is estimated to be approximately 1.5 hours 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. 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.

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