Form MP-1 Annual Report Form (Motor Carriers of Property)

OMB No.: 2126-0031  Expiration: XX/XX/XXXX



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 30 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. 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.

United States Department of Transportation
Federal Motor Carrier Safety Administration

FMCSA Office of Information Management
Annual Report Form (Motor Carriers of Passengers)

FORM MP-1

NAME OF MOTOR CARRIER:

MC NUMBER:

TRADE or DOING BUSINESS AS:

USDOT NUMBER:

ADDRESS: Street:

City:

State:

Zip Code:

-

TELEPHONE (include area code):

1. TYPE OF OPERATION based on major sources of revenue (check one):

Regular route service

Charter service

2. If respondent is a consolidated group, list and describe all entities making up the consolidation.

3. If a merger, consolidation, or change in the company or consolidated group occurred during the year, please describe.

(continued on next page)
FORM MP-1 Page 1 of 2

OMB No.: 2126-0031  Expiration: XX/XX/XXXX



Respondent only
4. Number of Passengers:

Consolidated

(a) Intercity regular route
(b) Charter or special
(c) Local or commuter
(d) Total passengers

5. Revenue:

(a) Intercity regular route

$

$

(b) Charter or special

$

$

(c) Local or commuter

$

$

(d) Express and other revenue

$

$

(e) Total operating revenue

$

$

6. Total Operating Expenses

$

$

7. Net Operating Income (Loss)

$

$

8. Other Income (Deductions)

$

$

9. Extraordinary Items, Net of Taxes

$

$

10. Total Provision for Income Taxes

$

$

11. Net Income (Loss)

$

$

12. Total Assets

$

$

13. Total Liabilities

$

$

14. Shareholders’ Equity

$

$

15. Operating Ratio

CERTIFICATION: I hereby certify that this report 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.

NAME (print or type)

TITLE

STREET ADDRESS

CITY

-

American
Alaska
Alabama
District
Delaware
Connecticut
Colorado
California
Arkansas
Arizona
Marshall
Maine
Louisiana
Kentucky
Kansas
Iowa
Indiana
Illinois
Idaho
Hawaii
Guam
Georgia
Florida
Nevada
Nebraska
Montana
Missouri
Mississippi
Minnesota
Micronesia
Michigan
Massachusetts
Maryland
New
North
Northern
Puerto
Pennsylvania
Palau
Oregon
Oklahoma
Ohio
Rhode
South
Virgin
Vermont
Utah
Texas
Tennessee
West
Washington
Virginia
Wyoming
Wisconsin
Hampshire
Jersey
Mexico
York
Virginia
Carolina
Dakota
Carolina
Dakota
Island
Islands
Rico
ofIslands
Marianas
Samoa
Columbia
STATE

ZIP CODE

SIGNATURE

RETURN THE COMPLETED
FORM TO:

TELEPHONE (include area code)
DATE

Department of Transportation
Federal Motor Carrier Safety Administration
Office of Registration and Safety Information (MC-RS)
1200 New Jersey Avenue SE
Washington, DC 20590

FORM MP-1 Page 2 of 2

Phone: (202) 366-4023
Fax: (202) 366-3477

SUBMIT FORM