OP-1(NNA) Application for U.S. Department of Transportation (USDOT

 

OMB No.: 2126-0016 Expiration: 05/31/2024

United States Department of Transportation
Federal Motor Carrier Safety Administration

Application for U.S. Department of Transportation (USDOT) Registration
by Non-North America-Domiciled Motor Carriers

INSTRUCTIONS for FORM OP-1(NNA)
Please read these instructions before completing the application form. Retain the
instructions and a copy of the completed application for the applicant’s records. These
instructions will assist an applicant in preparing an accurate and complete application.
Applications that do not contain the required information will be rejected and may result
in a loss of the application fee, if applicable. The application must be completed in English
and typed or printed in ink. If additional space is needed to provide a response to any
item, attach the information to the form. Identify the applicant on each supplemental
page and refer to the section and item number in the application for each response.

PURPOSE OF THIS APPLICATION FORM
The Form OP-1(NNA) is required to be filed by non-North America-domiciled for-hire motor carriers of passengers or property and
motor private carriers who wish to register to transport property or passengers in the United States.

WHAT TO FILE
All applicants must submit the following:
1. An original and one copy of a completed revised Form OP-1(NNA) Application for U.S. Department of Transportation (USDOT)
Registration by Non-North America-Domiciled Motor Carriers.
2. A signed and dated Form BOC-3, Designation of Agents for Service of Process, which reflects the applicant’s full and correct
name, as shown on the Form OP-1(NNA), and applicant’s address, including the street address, the city, state, country and zip
code, must be attached to the application, unless the applicant attaches a letter stating it will use a process agent service that
will submit the Form BOC-3 electronically. The BOC-3 form must show street address(es), and not post office box numbers, for
the person(s) designated as the agent(s) for service of process and administrative notices in connection with the enforcement
of any applicable Federal statutes or regulations. A person must be designated in each State in which the applicant will
operate. Please refer to the section “Legal Process Agents” for instructions for filing the Form BOC-3 when using a Process
Agent Service. The applicant may not begin operations unless the Form BOC-3 has been filed with the Federal Motor
Carrier Safety Administration.
3. A completed and signed Form MCS-150 Motor Carrier Identification Report.
4. If required under Section 3, a filing fee of $300 payable in U.S. dollars on a U.S. bank to the Federal Motor Carrier Safety
Administration, by means of a check, money order, or an approved credit card. Cash is not accepted.

GENERAL INSTRUCTIONS FOR
COMPLETING THE APPLICATION FORM
• All questions on the application form must be answered completely and accurately. If a question or supplemental attachment
does not apply to the applicant, it should be answered “not applicable.”
• The application must be typewritten or printed in ink. Applications written in pencil will be rejected.
• The application must be completed in English.
• The completed certification statements and oath must be signed by the applicant only. For example:
° If the company is a sole proprietorship, the owner must sign.
° If the company is a partnership, one of the partners must sign.
° If the company is a corporation, an official of the company must sign (President, Vice President, Secretary, Treasurer, etc.).

• The same person must sign the oath and certifications. An applicant’s attorney or any other representative is not permitted to sign.
FORM OP-1(NNA) Instructions • Page I of IV

Rev 6/3/2021

 

OMB No.: 2126-0016 Expiration: 05/31/2024

• Use the attachment pages included, as appropriate, to provide any descriptions, explanations, statements or other information
that is required to be furnished with the application. If additional space is needed to respond to any question, please use
separate sheets of paper. Identify the applicant on each supplemental page and refer to the section and item number in the
application for each response.
• Include only the city code and telephone number for telephone phone numbers. Do not include international access codes,
such as (011-52).

ADDITIONAL ASSISTANCE
Form OP-1(NNA) or MCS-150
Call 1-800-832-5660 for additional information on obtaining FMCSA registration numbers (USDOT or MC) or to monitor the status
of an application.
Safety Ratings
For information concerning a carrier's assigned safety rating, call 1-800-832-5660.
U.S. DOT Hazardous Material Regulations
To obtain information on whether the commodities an applicant intends to transport are considered as hazardous materials:
Refer to the provisions governing the transportation of hazardous materials found under Parts 100 through 180 of Title 49 of the
Code of Federal Regulations (CFR), particularly the Hazardous Materials Table at 49 CFR § 172.101 or visit the U.S. DOT, Pipeline and
Hazardous Materials Safety Administration web site: https://www.phmsa.dot.gov/phmsa-regulations. The web site also provides
information about DOT hazardous materials transportation registration requirements.

SPECIFIC INSTRUCTIONS FOR COMPLETING
EACH SECTION OF THE APPLICATION FORM
Section I. Applicant Information
Applicant's Legal Business Name and Doing Business As Name
The applicant’s name should be its full legal business name — the name on the incorporation certificate, partnership agreement,
tax records, etc. If the applicant uses a trade name that differs from its official business name, indicate this under “Doing Business
As Name.” Example: If the applicant is John Jones, doing business as Quick Way Trucking, enter “John Jones” under Legal Business
Name and “Quick Way Trucking” under Doing Business As Name.
Because the FMCSA uses computers to retain information about licensed carriers, it is important to spell, space, and punctuate any
name the same way each time the applicant writes it. Example: John Jones Trucking Co., Inc.; J. Jones Trucking Co., Inc.; and John
Jones Trucking are considered three separate companies.
Business Address/Mailing Address
The business address is the physical location of the business (for example, 24 Calle 10-08 Zona 11 Granai 2, Quetzaltenago, Guatemala).
If applicant receives mail at an address different from the business location, then provide the mailing address as well (for example,
P.O. Box 3721).
To receive FMCSA notices and to ensure that insurance documents filed on applicant’s
behalf are accepted, notify in writing the Federal Motor Carrier Safety Administration,
MC-RS, W65-206, 1200 New JerseyAvenue, S.E., Washington, DC 20590, if the business or
mailing address changes. If applicant also maintains an office in the United States, that
information should also be provided.
Representative
If someone other than the applicant is preparing this form, or otherwise assisting the applicant in completing the application,
provide the representative’s name, title, position, or relationship to the applicant, address, and telephone and fax numbers.
Applicant’s representative will be the person contacted if there are questions concerning this application.
U.S. DOT Number
Applicants are required to obtain a U.S. DOT Number from the U.S. Department of Transportation (U.S. DOT) before initiating
service. Motor carriers that already have been issued a U.S. DOT Number should provide it. Applicants that have not previously
obtained a U.S. DOT Number will be issued a U.S. DOT number along with their DOT registration.
A completed and signed Form MCS-150 Motor Carrier Identification Report must be
submitted along with this application.

FORM OP-1(NNA) Instructions • Page II of IV

 

OMB No.: 2126-0016 Expiration: 05/31/2024

Form of Business
A business is a corporation, a sole proprietorship, or a partnership. If the business is a sole proprietorship, provide the name of the
individual who is the owner. In this situation, the Owner is the registration applicant. If the business is a partnership, provide the
full name of each partner.

Section 1A. Additional Applicant Information
All applicants must answer each question in this section. The applicant must provide the requested information concerning its
current operations in the United States and any motor carrier registration issued by any Non-North American government.

Section 2. Affiliations Information
All applicants must disclose pertinent information concerning any relationships or affiliations which the applicant has had with other
entities registered with FMCSA or its predecessor agencies. Applicant must indicate whether these entities have been disqualified
from operating commercial motor vehicles anywhere in the United States.

Section 3. Type(s) of Registration Requested
Check the appropriate box(es) for the type(s) of registration the applicant is requesting. A separate filing fee is required for certain
types of registration requested. Section 3 describes those types. Filing fees are waived for for-hire motor carriers exempt under 49
United States Code, Chapter 135, Subchapter I.

Section 4. Insurance Information
Check the appropriate box(es) that describes the type(s) of business the applicant will be conducting.
If the applicant is applying for motor passenger carrier registration, check the box that describes the seating capacity of its vehicles.
If all the vehicles the applicant operates have a seating capacity of 15 passengers or fewer, the applicant must maintain $1,500,000
minimum liability coverage. If any one of the vehicles the applicant operates has a seating capacity of 16 passengers or more, the
applicant must maintain $5,000,000 minimum liability coverage.
If the applicant is applying for motor property carrier registration and it operates vehicles with a gross vehicle weight rating of 10,001
pounds or more and hauls only non-hazardous materials, the applicant must maintain $750,000 minimum liability coverage for
the protection of the public. Hazardous materials referred to in the FMCSA’s insurance regulations in item (iii) of the table at 49 CFR
387.303 (b)(2) require $1 million minimum liability coverage; those in item (ii) of the table at 49 CFR 387.303 (b)(2) require $5 million
minimum liability coverage.
If the applicant operates only vehicles with a gross vehicle weight rating of less than 10,001 pounds but will be transporting any
quantity of Division 1.1, 1.2 or 1.3 explosives, any quantity of poison gas (Division 2.3, Hazard Zone A, or Division 6.1, Packing Group
1, Hazard Zone A materials), or highway route controlled quantity of radioactive materials, the applicant must maintain $5 million
minimum liability coverage.
Applicant does not have to submit evidence of insurance with the application. However, applicant will be required to present
acceptable evidence of necessary insurance coverage to the FMCSA as part of a pre-authorization safety audit. Appropriate insurance
forms must be filed within 90 days after the applicant submits its application: These include Form BMC-91 or BMC-91X for bodily
injury and property damage for all applicants and Form BMC-34 for cargo insurance (household goods carriers only).
The FMCSA does not furnish copies of insurance forms. The applicant must contact its insurance company to arrange for the filing of
all required insurance forms.
If an application is granted by the FMCSA, DOT registration is still not effective
and operations under that registration may not begin unless an insurance filing
has been made with and accepted by the FMCSA as required under 49 CFR 387.7,
387.31 and 387.301.

Section 5. Safety Certifications
Applicants for motor carrier registration must complete the safety certifications. The applicant should check the “YES” response only
if the applicant can attest to the truth of the statements. The carrier official’s signature at the end of this section applies to the Safety
Certifications. The “Applicant’s Oath” at the end of the application form applies to all certifications. False certifications are subject to
the penalties described in that oath.
Applicants should complete all applicable Attachment pages and, if necessary to complete the responses, attach additional pages
identifying the applicant on each supplemental page and referring to the section and item number in the application for each response.

FORM OP-1(NNA) Instructions • Page III of IV

 

OMB No.: 2126-0016 Expiration: 05/31/2024

Section 6. Household Goods Requirements
Applicants applying for registration as a household goods motor carrier as defined in 49 U.S.C. 13102(12) must provide certain
information regarding their arbitration program and tariff. They must also certify they are familiar with FMCSA’s consumer protection
requirements applicable to household goods transportation. Applicants must disclose all relationships involving common stock,
common ownership, common management, or common familial relationships between the applicant and any other motor carrier,
freight forwarder, or broker of household goods within 3 years of the date of the filing of this application. The signature should be
that of the same company official who completes the Applicant’s Oath.

Section 7. Scope of Operating Registration Sought
Applicant must indicate, by checking one or more boxes, the description(s) of the registration(s) for which application is being made.

Section 8. Compliance Certifications
All applicants are required to certify accurately to their willingness and ability to comply with statutory and regulatory requirements
and to their understanding that their agent for service of process is their official representative in the U.S. to receive filings and
notices in connection with enforcement of any Federal statutes and regulations.
Applicants are required to certify their willingness to produce records for the purpose of determining compliance with the applicable
safety regulations of the FMCSA.
Applicants are required to certify that they are not now prohibited from filing an application because a previously granted FMCSA
registration is currently under suspension or was revoked less than 30 days before the filing of this application.

Section 9. Applicant's Oath
The applicant or an authorized representative may prepare applications. In either case, the applicant must sign the oath and all
safety certifications. (For information on who may sign, see “General Instructions for Completing the Application Form” in the
instructions for this application.)

LEGAL PROCESS AGENTS
All motor carrier applicants must designate a process agent in each State where operations are conducted. For example, if the applicant
will operate only in California and Arizona, it must designate an agent in each of those States; if the applicant will operate in only one
State, an agent must be designated for that State only. Process agents who will accept filings and notices on behalf of the applicant are
designated on FMCSA Form BOC-3. Form BOC-3 must be filed with the application, unless the applicant uses a Process Agent Service. If
the applicant opts to use a Process Agent Service, it must submit a letter with the application informing the FMCSA of this decision and
have the Process Agent Service electronically file the BOC-3 with FMCSA within 90 days after the applicant submits its application.
Applicants may not begin operations unless Form BOC-3 has been filed with FMCSA.

STATE NOTIFICATION
Before beginning operations, all applicants must contact the appropriate regulatory agencies in every State in and through which
the carrier will operate to obtain information regarding various State rules applicable to interstate registrations. It is the applicant’s
responsibility to comply with registration, fuel tax, and other State regulations and procedures. Please refer to the additional
information provided in the application packet for further information.

MAILING INSTRUCTIONS
To file for registration an applicant must submit an original and one copy of this application with the appropriate filing fee to
FMCSA. Note: Retain a copy of the completed application form and any attachments for the applicant’s records.
Check or Money Order (make payable to FMCSA in U.S. dollars)
First-Class Mail
Federal Motor Carrier Safety Administration
P.O. Box 6200-33
Portland, OR 97228-6200

Express Mail
U.S. Bank Government Lockbox
Attn: Federal Motor Carrier Safety
Administration 6200-33
17650 NE Sandy Blvd.
Portland, OR 97230

Note: Sending payment to the wrong address will delay application processing by 2-3 weeks.

FORM OP-1(NNA) Instructions • Page IV of IV

Credit Card (MasterCard or Visa only)
Federal Motor Carrier Safety Administration
1200 New Jersey Avenue SE
Room W65-206
Washington, DC 20590

 

OMB No.: 2126-0016 Expiration: 05/31/2024

Please note, the expiration date as stated on this form relates to the process for renewing the Information Collection Request for this
form with the Office of Management and Budget. This requirement to collect information as requested on this form does not expire.
For questions, please contact the Office of Registration and Safety Information, Registration, Licensing, and Insurance Division.
Docket # MC

FOR FMCSA USE ONLY

Fee #

USDOT #

CC Approval #

Filed:

Application Tracking #

The collection of this information is authorized under the provisions of 49 U.S.C. 31144 and 13902. Public reporting for this collection of information is
estimated to be four 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 law. 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 2126-0016. 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, U.S. Department of Transportation, Washington, D.C., 20590.

United States Department of Transportation
Federal Motor Carrier Safety Administration

Application for U.S. Department of Transportation (USDOT) Registration
by Non-North America-Domiciled Motor Carriers

FORM OP-1(NNA)
Section

1

APPLICANT INFORMATION

LEGAL BUSINESS NAME:
DOING BUSINESS AS NAME (trade name, if any):
BUSINESS ADDRESS (actual street address):
STREET ADDRESS/ROUTE NUMBER

CITY
STATE/PROVINCE

MAILING ADDRESS (if different than above):

COLONIA (Mexico only)

Same as business address

CITY
STATE/PROVINCE

Not applicable

ZIP CODE

Mailing address below:

STREET ADDRESS/ROUTE NUMBER

U.S. ADDRESS:

COUNTRY

COLONIA (Mexico only)

COUNTRY

ZIP CODE

Applicant currently has an office in the United States, entered below:

STREET ADDRESS/ROUTE NUMBER

CITY
STATE/TERRITORY

ZIP CODE

FORM OP-1(NNA) • Page 1 of 16

TELEPHONE NUMBER

FAX NUMBER

Rev 6/3/2021

 

OMB No.: 2126-0016 Expiration: 05/31/2024

APPLICANT'S REPRESENTATIVE (person who can respond to inquiries):
TITLE, POSITION or RELATIONSHIP TO APPLICANT

NAME
STREET ADDRESS/ROUTE NUMBER
STATE/PROVINCE

CITY

COUNTRY

ZIP CODE

TELEPHONE NUMBER

FAX NUMBER

U.S. DEPARTMENT OF TRANSPORTATION NUMBER (if available):
FORM OF BUSINESS (check one):
CORPORATION (give foreign, U.S., or other State of incorporation):

SOLE PROPRIETORSHIP (give full name of individual):
FIRST NAME

MIDDLE NAME

SURNAME

PARTNERSHIP (give full name of each partner):

Section

1A

FIRST NAME

MIDDLE NAME

SURNAME

FIRST NAME

MIDDLE NAME

SURNAME

FIRST NAME

MIDDLE NAME

SURNAME

ADDITIONAL
APPLICANT INFORMATION
DOES THE APPLICANT CURRENTLY OPERATE IN THE UNITED STATES?

Yes

No

• If yes, indicate where the applicant operates:

• If yes, indicate the ports of entry utilized:

HAS THE APPLICANT PREVIOUSLY COMPLETED AND SUBMITTED A FORM MCS-150?
• If yes, give the name under which it was submitted:

FORM OP-1(NNA) • Page 2 of 16

Yes

No

 

OMB No.: 2126-0016 Expiration: 05/31/2024

DOES THE APPLICANT PRESENTLY HOLD, OR HAS IT EVER APPLIED FOR OPERATING AUTHORITY OR
REGISTRATION FROM THE FORMER U.S. INTERSTATE COMMERCE COMMISSION, THE U.S. FEDERAL
HIGHWAY ADMINISTRATION, THE OFFICE OF MOTOR CARRIER SAFETY, OR THE FEDERAL MOTOR
CARRIER SAFETY ADMINISTRATION OF THE U.S. DEPARTMENT OF TRANSPORTATION UNDER THE
NAME SHOWN ON THIS APPLICATION, OR UNDER ANY OTHER NAME?

Yes

No

Yes

No

• If yes, please identify the lead docket number(s) assigned
to the application or grant of authority or registration:
• If the application was rejected before the time a lead docket number(s) was assigned,
please provide the name of the applicant shown on the application:
• If yes, did FMCSA revoke the applicant’s operating authority or provisional registration because
the applicant failed to receive a Satisfactory safety rating or because the FMCSA otherwise
determined the applicant’s basic safety management controls were inadequate?

• If the applicant answered yes to the previous question, it must explain how it has corrected the deficiencies that resulted in
revocation, explain what effectively functioning basic safety management systems the applicant has in place, and provide any
information and documents that support its case. (If the applicant requires more space, attach the information to this form.)

ATTACH
FILE

DOES THE APPLICANT HOLD A FEDERAL TAX NUMBER FROM THE U.S. GOVERNMENT?

Yes

No

Yes

No

• If yes, enter the number here:
IS THE APPLICANT REQUIRED TO REGISTER AS A MOTOR CARRIER WITH ANY
NON-NORTH AMERICAN GOVERNMENT?
• If yes, give the name under which the applicant is registered with the non-North American government, the applicant's
registration number, and the name of the non-North American government that issued the registration.
REGISTRATION NAME

REGISTRATION NUMBER

• If applicant has applied to register with a non-North American government
but has not yet been registered, indicate the application date:

FORM OP-1(NNA) • Page 3 of 16

GOVERNMENT ISSUING REGISTRATION

 

Section

2

OMB No.: 2126-0016 Expiration: 05/31/2024

AFFILIATIONS INFORMATION
Disclose any relationship the applicant has, or has had, with any U.S. or foreign motor carrier, broker, or freight forwarder registered
with the former ICC, FHWA, Office of Motor Carrier Safety, or Federal Motor Carrier Safety Administration within the past three years.
For example, this relationship could be through a percentage of stock ownership, a loan, a management position, a wholly-owned
subsidiary, or other arrangement.
If this requirement applies to the applicant, provide the name of the affiliated company, the latter’s MC or MX number, its U.S. DOT
Number, if any, and the company’s latest U.S. DOT safety rating. Applicant must indicate whether these entities have been disqualified
from operating commercial motor vehicles anywhere in the United States. (If the applicant requires more space, attach the information
to this form.)

MC or MX
Number

Name of affiliated company

U.S. DOT
Number

U.S. DOT
Safety Rating

Ever disqualified
from operating
CMVs in the U.S.?
Yes

No

Yes

No

Yes

No

ATTACH
FILE

Section

3

TYPE(S) OF
REGISTRATION REQUESTED
Applicant must submit a filing fee for certain types of registration requested (each checked box is one of those types).
Applicant seeks to provide the following transportation service(s):
PASSENGER REGISTRATION (check all that apply):
For-Hire Motor Carrier of Passengers. ($300 fee required; fee is waived if carrier is exempt under 49 U.S.C. Chapter 135,
Subchapter I.)
Private Motor Carrier of Passengers. (No fee required.)
PROPERTY REGISTRATION (check all that apply):
For-Hire Motor Carrier of Property (except Household Goods). ($300 fee required; fee is waived if carrier is exempt under 49
U.S.C. Chapter 135, Subchapter I.)
For-Hire Motor Carrier of Household Goods. ($300 fee required.)
Motor Private Carrier. (No fee required.)

FORM OP-1(NNA) • Page 4 of 16

 

Section

4

OMB No.: 2126-0016 Expiration: 05/31/2024

INSURANCE INFORMATION
MOTOR PASSENGER CARRIER APPLICANTS
All motor passenger carriers operating in the United States, including non-North America-domiciled carriers, must maintain public
liability insurance. The amounts in parentheses represent the minimum amount of coverage required.
Applicant will use (check only one):
Any vehicle with a seating capacity of 16 passengers or more ($5,000,000)
Only vehicles with a seating capacity of 15 passengers or fewer ($1,500,000)
MOTOR PROPERTY CARRIER APPLICANTS (including Household Goods Carriers; check all that apply, if any)
NOTE: Refer to Section 4 in the "Instructions for Form OP-1(NNA)" for information on cargo insurance filing requirements for
household goods carriers.
Applicant will operate vehicles having a gross vehicle weight rating (GVWR) of 10,001 pounds or more to transport:
Non-hazardous commodities ($750,000);
Hazardous materials referenced in the FMCSA insurance regulations at 49 CFR § 387.303(b)(2)(c) ($1,000,000);
Hazardous materials referenced in the FMCSA insurance regulations at 49 CFR § 387.303(b)(2)(b) ($5,000,000).
Applicant will operate only vehicles having a GVWR under 10,001 pounds to transport:
• any quantity of Division 1.1, 1.2 or 1.3 explosives; and/or
• any quantity of poison gas (Division 2.3, Hazard Zone A or Division 6.1, Packing Group 1, Hazard Zone A materials); and/or
• highway route controlled quantity of radioactive materials ($5,000,000).
Does the applicant presently hold public liability insurance?

Yes

No

If the applicant does hold such insurance, please provide the information below:
INSURANCE COMPANY

POLICY NUMBER

MAXIMUM INSURANCE AMOUNT

STREET ADDRESS/ROUTE NUMBER

STATE/PROVINCE

COUNTRY

DATE ISSUED

INSURANCE EFFECTIVE DATE

FORM OP-1(NNA) • Page 5 of 16

ZIP CODE

INSURANCE EXPIRATION DATE

 

Section

5

OMB No.: 2126-0016 Expiration: 05/31/2024

SAFETY CERTIFICATIONS
Applicant maintains current copies of all U.S. DOT Federal Motor Carrier Safety Regulations, Federal Motor Vehicle Safety
Standards, and the Hazardous Materials Regulations (if a property carrier transporting hazardous materials), understands and
will comply with such Regulations, and has ensured that all company personnel are aware of the current requirements.

Yes

Applicant certifies that the following tasks and measures will be fully accomplished and
procedures fully implemented before it commences operations in the United States.

Part 1. Driver qualifications:
The carrier has in place a system and procedures for ensuring the continued qualification of drivers to operate safely, including
a safety record for each driver, procedures for verification of proper licensing of each driver, procedures for identifying drivers
who are not complying with the U.S. safety regulations, and a description of a retraining and educational program for poorly
performing drivers.

Yes

The carrier has procedures in place to review drivers’ employment and driving histories for at least the last 3 years, to determine
whether the individual is qualified and competent to drive safely.

Yes

The carrier has established a program to review the records of each driver at least once every 12 months and will maintain a
record of the review.

Yes

The carrier will ensure, once operations in the United States have begun, that all of its drivers operating in the United States are at
least 21 years of age and possess a valid Commercial Drivers License or Non-Resident Commercial Drivers License.

Yes

Part 2. Hours of service:
The carrier has in place a record keeping system and procedures to monitor the hours of service performed by drivers, including
procedures for continuing review of drivers’ log books, and for ensuring that all operations requirements are complied with.

Yes

The carrier has ensured that all drivers to be used in the United States are knowledgeable of the U.S. hours of service
requirements, and the carrier has clearly and specifically instructed the drivers concerning the application to them of
the 11 hour, 14 hour, and 60 and 70 hour rules, as well as the requirement for preparing daily log entries in their own
handwriting for each 24 hour period.

Yes

The carrier has attached to this application (see page 9) statements describing the monitoring procedures to ensure that
drivers complete logbooks correctly, and describing the carrier’s record keeping and driver review procedures.

Yes

The carrier will ensure, once operations in the United States have begun, that its drivers operate within the hours-of-service rules
and are not fatigued while on duty.

Yes

Part 3. Drug and alcohol testing:
The carrier is familiar with the alcohol and controlled substance testing requirements of 49 CFR part 382 and 49 CFR part 40
and has in place a program for systematic testing of drivers.

Yes

The carrier has attached to this application (see page 9) the name, address, and telephone number of the person(s)
responsible for implementing and overseeing alcohol and drug programs, and also of the drug testing laboratory and alcohol
testing service that are used by the company.

Yes

Part 4. Vehicle condition:
The carrier has established a system and procedures for inspection, repair and maintenance of its vehicles in a safe condition,
and for preparation and maintenance of records of inspection, repair and maintenance in accordance with the U.S. DOT’s
Federal Motor Carrier Safety Regulations and the Hazardous Materials Regulations.

Yes

The carrier has inspected all vehicles that will be used in the United States before the beginning of such operations and has
proof of the inspection on-board the vehicle as required by 49 CFR 396.17.

Yes

The carrier will ensure, once operations in the United States have begun, that all vehicles it operates in the United States were
manufactured or have been retrofitted in compliance with the applicable U.S. DOT Federal Motor Vehicle Safety Standards in
effect at the time of manufacture.

Yes

FORM OP-1(NNA) • Page 6 of 16

 

OMB No.: 2126-0016 Expiration: 05/31/2024

The carrier will ensure that all vehicles operated in the United States are inspected at least every 90 days by a certified
inspector in accordance with the requirements for a Level I Inspection under the criteria of the North American Standard
Inspection, as defined in 49 CFR 350.105, once operations in the United States begin and until such time as the carrier has held
permanent registration from the FMCSA for at least 36 consecutive months. After the 36-month period expires, the carrier will
ensure that all vehicles operated in the United States are inspected in accordance with 49 CFR 396.17 at least once every 12
months thereafter.

Yes

The carrier will ensure, once operations in the United States have begun, that all violations and defects noted on inspection
reports are corrected before vehicle and drivers are permitted to enter the United States.

Yes

Part 5. Accident monitoring program:
The carrier has in place a program for monitoring vehicle accidents and maintains an accident register in accordance with
49 CFR 390.15.

Yes

The carrier has attached to this application (see page 10) a copy of its accident register for the previous 12 months, or a
description of how the company will maintain this register once it begins operations in the United States.

Yes

The carrier has established an accident countermeasures program and a driver training program to reduce accidents.

Yes

The carrier has attached to this application (see page 11) a description and explanation of the accident monitoring program it
has implemented for its operations in the United States.

Yes

Part 6. Production of records:
The carrier can and will produce records demonstrating compliance with the safety requirements within 48 hours of receipt of
a request from a representative of the USDOT/FMCSA or other authorized Federal or State official.

Yes

The carrier is including as an attachment to this application (see page 11) the name, address and telephone number of the
employee to be contacted for requesting records.

Yes

Part 7. Hazardous materials:
(To be completed by carriers of hazardous materials only.)
The hazardous materials carrier has full knowledge of the U.S. DOT Hazardous Materials Regulations, and has established
programs for the thorough training of its personnel as required under 49 CFR part 172, Subpart H, and 49 CFR 177.816. The
hazardous materials carrier has attached to this application (see page 12) a statement providing information concerning: (1)
the names of employees responsible for ensuring compliance with hazardous materials regulations; (2) a description of their
hazardous materials safety functions; and (3) a copy of the information used to provide hazardous materials training.

Yes

The carrier has established a system and procedures for inspection, repair and maintenance of its reusable hazardous
materials packages (cargo tanks, portable tanks, cylinders, intermediate bulk containers, etc.) in a safe condition, and for
preparation and maintenance of records of inspection, repair, and maintenance in accordance with the U.S. DOT Hazardous
Materials Regulations.

Yes

The hazardous materials carrier has established a system and procedures for filing and maintaining hazardous materials
shipping documents.

Yes

The hazardous materials carrier has a system in place to ensure that all hazardous materials trucks are marked and placarded
as required by 49 CFR part 172, Subparts D and F.

Yes

The carrier will register under 49 CFR part 107, Subpart G, if transporting any quantity of hazardous materials requiring the
vehicle to be placarded.

Yes

Part 7A. For cargo tank carriers of hazardous materials:
(To be completed by cargo tank carriers of hazardous materials only.)
The carrier submits with this application (see page 12) a certificate of compliance for each cargo tank the company utilizes
in the U.S., together with the name, qualifications, cargo tank number, and cargo tank number registration statement of the
facility the carrier will be utilizing to conduct the test and inspections of such tanks required by 49 CFR part 180.

Yes

Signature of Applicant:
By signing these certifications, the carrier official is on notice that the representations made herein are subject to verification through inspections in
the United States and through the request for and examination of records and documents. Failure to support the representations contained in this
application could form the basis of a proceeding to assess civil penalties and/or lead to the revocation of the authority granted.

FORM OP-1(NNA) • Page 7 of 16

 

Section

5A

OMB No.: 2126-0016 Expiration: 05/31/2024

SAFETY AND COMPLIANCE
INFORMATION AND ATTACHMENTS
INDIVIDUAL(S) RESPONSIBLE FOR SAFE OPERATIONS AND COMPLIANCE WITH APPLICABLE REGULATORY AND
SAFETY REQUIREMENTS:
NAME

ADDRESS

POSITION

NAME

ADDRESS

POSITION

LOCATION WHERE CURRENT COPIES OF THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS AND OTHER REGULATIONS
ARE MAINTAINED:

ATTACH
FILE

ATTACHMENT FOR SECTION 5,
PART 1 ("Driver qualifications")
INTENTIONALLY LEFT BLANK

FORM OP-1(NNA) • Page 8 of 16

 

OMB No.: 2126-0016 Expiration: 05/31/2024

ATTACHMENT FOR SECTION 5,
PART 2 ("Hours of service")
MONITORING STATEMENTS
Statements describing monitoring procedures for ensuring correctness of logbook completion by drivers and describing record
keeping and driver review procedures.

ATTACH
FILE

ATTACHMENT FOR SECTION 5,
PART 3 ("Drug and alcohol testing")
PERSON(S) RESPONSIBLE FOR IMPLEMENTING AND OVERSEEING ALCOHOL AND DRUG PROGRAMS:
NAME

ADDRESS

POSITION

NAME

ADDRESS

POSITION

NAME

ADDRESS

POSITION
ATTACH
FILE

DRUG TESTING LABORATORIES AND ALCOHOL TESTING SERVICES THAT ARE USED BY THE CARRIER:
NAME

ADDRESS

TELEPHONE NUMBER

NAME

ADDRESS

TELEPHONE NUMBER

NAME

ADDRESS

TELEPHONE NUMBER

ATTACH
FILE

FORM OP-1(NNA) • Page 9 of 16

 

OMB No.: 2126-0016 Expiration: 05/31/2024

ATTACHMENT FOR SECTION 5,
PART 4 ("Vehicle condition")
INTENTIONALLY LEFT BLANK

ATTACHMENT FOR SECTION 5, PART 5
("Accident monitoring program")
1. DESCRIBE HOW COMPANY WILL MAINTAIN ACCIDENT REGISTER [49 CFR 390.15(b)] ONCE IT BEGINS OPERATIONS IN U.S.:

ATTACH
FILE

FORM OP-1(NNA) • Page 10 of 16

 

OMB No.: 2126-0016 Expiration: 05/31/2024

ATTACHMENT FOR SECTION 5, PART 5
("Accident monitoring program") cont'd
2. DESCRIBE AND EXPLAIN ACCIDENT MONITORING PROGRAM FOR OPERATIONS IN U.S. [49 CFR 391.25 and 391.27]:

ATTACH
FILE

ATTACHMENT FOR SECTION 5,
PART 6 ("Production of records")
CONTACT PERSON(S) FOR REQUESTING RECORDS:
NAME

ADDRESS

TELEPHONE NUMBER

NAME

ADDRESS

TELEPHONE NUMBER

NAME

ADDRESS

TELEPHONE NUMBER
ATTACH
FILE

FORM OP-1(NNA) • Page 11 of 16

 

OMB No.: 2126-0016 Expiration: 05/31/2024

ATTACHMENT FOR SECTION 5, PART 7
("Hazardous materials")
STATEMENT RESPECTING PERSON(S) (OTHER THAN DRIVERS) RESPONSIBLE FOR ENSURING COMPLIANCE WITH
HAZARDOUS MATERIAL REGULATIONS (49 CFR 172.704) FOR HAZARDOUS MATERIAL ACTIVITIES:
(To be completed by Carriers of Hazardous Materials only.)

ATTACH
FILE

ATTACHMENT FOR SECTION 5, PART 7A ("For
cargo tank carriers of hazardous materials")
CARGO TANK INFORMATION (HAZARDOUS MATERIALS) (49 CFR part 180, Subpart E):
(To be completed by Cargo Tank Carriers of Hazardous Materials only.)

ATTACH
FILE

FORM OP-1(NNA) • Page 12 of 16

 

Section

6

OMB No.: 2126-0016 Expiration: 05/31/2024

HOUSEHOLD GOODS
REQUIREMENTS
HOUSEHOLD GOODS MOTOR CARRIER APPLICANTS MUST :
1. Provide evidence of participation in an arbitration program and a copy of the notice they provide to shippers of the availability of
binding arbitration.
2. Identify their tariff and provide a copy of the notice to shippers of the availability of that tariff for inspection, indicating how that
notice is provided.
3. Disclose all relationships involving common stock, common ownership, common management, or common familial relationships
between the applicant and any other motor carrier, freight forwarder, or broker of household goods within 3 years of the date of
the filing of this application.
Applicant certifies that it has access to, has read, is familiar with, and will observe all applicable Federal laws relating to consumer
protection, estimating, consumers’ rights and responsibilities, and options for limitations of liability for loss and damage.

APPLICANT SIGNATURE

Common
Stock

Name of affiliated company

Common
Ownership

Common
Management

Family
Relation

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

ATTACH
FILE

Section

7

SCOPE OF REGISTRATION
SOUGHT
1. Applicant seeks to provide the following transportation service in foreign/international commerce (check all that apply):
For a non-North American carrier to transport property between points outside of United States and all points in the United States.
For non-North American passenger carriers, charter and tour bus operations between points outside of United States and points
in the United States.
For a non-North American passenger carrier to provide transportation services as a private motor carrier of passengers.
2. Indicate the principal border crossing points which applicant intends to utilize:

ATTACH
FILE

FORM OP-1(NNA) • Page 13 of 16

 

Section

8

OMB No.: 2126-0016 Expiration: 05/31/2024

COMPLIANCE CERTIFICATIONS
ALL APPLICANTS MUST CERTIFY AS FOLLOWS:
Applicant is willing and able to provide the proposed operations or service and to comply with all pertinent statutory and
regulatory requirements and regulations issued or administered by the U.S. Department of Transportation, including operational
regulations, safety fitness requirements, motor vehicle safety standards, and minimum financial responsibility requirements.

Yes

Applicant understands that the agent(s) for service of process designated on FMCSA Form BOC-3 will be deemed applicant’s
official representative(s) in the United States for receipt of filings and notices in administrative proceedings under 49 U.S.C.
13303, and for receipt of filings and notices issued in connection with the enforcement of any Federal statutes or regulations.

Yes

Applicant is willing and able to produce for review or inspection documents which are requested for the purpose of
determining compliance with applicable statutes and regulations administered by the Department of Transportation,
including the Federal Motor Carrier Safety Regulations, Federal Motor Vehicle Safety Standards and Hazardous Materials
Regulations, within 48 hours of any written request. Applicant understands that the written request may be served on the
person identified in the attachment for Section 5, number 6, or the designated agent for service of process.

Yes

Applicant is willing and able to have all vehicles operated in the United States inspected at least every 90 days by a certified
inspector and have decals affixed attesting to satisfactory compliance with applicable inspection criteria. This requirement will
end after applicant has held permanent registration from FMCSA for three consecutive years.

Yes

Applicant is not presently disqualified from operating a commercial vehicle in the United States.

Yes

Applicant is not prohibited from filing this application because its FMCSA registration is currently under suspension or was
revoked less than 30 days before the filing of this application.

Yes

APPLICANT SIGNATURE

All motor carriers operating within the United States, including non-North American
motor carriers applying for operating authority under this form, 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 an OSHA state plan agency pursuant to Section 18 of the Occupational
Safety and Health Act of 1970. 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.

FORM OP-1(NNA) • Page 14 of 16

 

Section

9

OMB No.: 2126-0016 Expiration: 05/31/2024

APPLICANT'S OATH
APPLICANT'S OATH MUST BE COMPLETED (AND SIGNED) BY APPLICANT
I,

(First Name)

(Middle Name)

, verify under penalty of perjury, under the laws of the United States of

(Last Name)

America, that I understand the foregoing certifications and that all responses are true and correct. I certify that I am qualified and authorized to file this
application. I know that willful misstatement or omission of material facts constitute Federal criminal violations under 18 U.S.C. §§ 1001 and 1621 and that
each offense is punishable by up to 5 years imprisonment and a fine under Title 18, United States Code, or civil penalties under 49 U.S.C. §521(b)(2)(B) and
49 U.S.C. Chapter 149.
I further certify that I have not been convicted in U.S. Federal or State courts, after September 1, 1989, of any offense involving the distribution or possession
of controlled substances, or that if I have been so convicted, that I am not ineligible to receive U.S. Federal benefits, either by court order or operation of law,
pursuant to Section 5301 of the Anti-Drug Abuse Act of 1988 (21 U.S.C. 862).

Signature:

Date:

FORM OP-1(NNA) • Page 15 of 16

Title:

 

Section

10

OMB No.: 2126-0016 Expiration: 05/31/2024

FMCSA FILING FEES

Fee schedule effective January 1996.
Applicants must submit a filing fee of $300.00 for each type of
registration that requires a filing fee. The total amount due is equal
to the fee(s) times the number of boxes checked in Section 3 (where a
filing fee applies) of the Form OP-1(NNA). Fees for multiple authorities
may be combined in a single payment.

Filing fees apply only to For-Hire carriers of passengers or property. The fee is waived if a For-Hire carrier is exempt under 49 U.S.C.
Chapter 135, Subchapter I.
Filing fees must be payable to the Federal Motor Carrier Safety Administration, by check drawn upon funds deposited in a bank in the
United States or money order payable in U.S. currency or by approved credit card.
Separate fees are required for each type of registration requested. If applicant requests registration as a for-hire motor carrier and as a
motor private carrier, multiple fees are required. The applicant may submit a single payment for the sum of the applicable fees.
Filing fees must be sent along with the original and one copy of the application to the appropriate address under the paragraph titled
"MAILING INSTRUCTIONS" on page IV of the instructions to this form.
After an application is received, the filing fee is non-refundable.
An application submitted with a personal check will be held for 30 days from the date received. The FMCSA reserves the right to
discontinue processing any application for which a check is returned due to insufficient funds. No application will be processed until
the fee is paid in full.
Total number of boxes checked in Section 3 requiring a filing fee:
INDICATE AMOUNT: $

× $300 = $

AND METHOD OF PAYMENT (check one):

CHECK or

MONEY ORDER, payable to:

Federal Motor Carrier Safety Administration

VISA

MASTERCARD

DISCOVER

CREDIT CARD NUMBER (sixteen digits)
SIGNATURE OF CARD OWNER

AMERICAN EXPRESS

,

CARD EXPIRATION DATE (month, year)

,

31st
30th
29th
28th
27th
26th
25th
24th
23rd
22nd
21st
20th
19th
18th
17th
16th
15th
14th
13th
12th
11th
10th
9th
8th
7th
6th
5th
4th
3rd
2nd
1st
December
November
October
September
August
July
June
May
April
March
February
January
2024
2023
2022
2021
2020
DATE APPLICATION WAS COMPLETED
(month, day, year)

FORM OP-1(NNA) • Page 16 of 16