***IMPORTANT: YOU MUST SCROLL DOWN TO SIGN, THEN HIT "AGREE & SIGN" BUTTON***
APPLICATION FOR SERVICES
PERMIT AND FUEL TAX REPORTING ***ORIGINAL APPLICATION***
Date of Application: May 29, 2026
GENERAL COMPANY INFORMATION
Business Legal Name or Individual Name:
DBA:
Business Address: ,
Phone Number: Fax Number:
Email Address:
Federal ID#:
Type of Business:
Sole Proprietor:
How did you hear about Road Ready?
PERSON TO CONTACT REGARDING PERMITS
Name:
Email:
Phone:
Fax:
Preferred Method of Contact:
STATUS OF CITIZENSHIP FOR DOT PURPOSES
Are you a U.S. Citizen:
Are you a U.S. Resident:
MAILING INFORMATION
Mailing Address (if different from above):
,
OFFICERS/PARTNERS/OWNER
President/Partner/Owner:
Drivers License:
State:
Address: ,
Name:
Phone #:
PERMITS
Please list all account numbers for all permits that your company currently holds:
Do you already have permits?:
US DOT#:
DOT PIN:
MC/ICC#:
MC PIN:
REQUESTER CODE#:
HAZARDOUS MATERIALS #:
IFTA#:
NM:
KYU:
NY:
OR:
Are you leased to a carrier?:
If leased to Carrier
Name:
DOT#:
Fed ID:
TYPE OF CARRIER
Please place an "X" next to type of carrier:
Type of Carrier:
Do You Haul:
UNIT AND DRIVER INFORMATION
# of Power Units:
# of Trailers:
# of Drivers Employed By Your Company:
PRODUCTS HAULED FOR DOT PURPOSES
Please list all products your company hauls:
Do you haul hazardous waste products:
EQUIPMENT TERMINAL LOCATION IS MANDATORY FOR CHP PURPOSES
Terminal (where truck(s) are parked)
Address: ,
Person to Contact at Location:
Phone:
EMERGENCY CONTACTS FOR CHP PURPOSES
First Contact Name:
Phone #:
Second Contact Name:
Phone #:
AUTHORITIES REQUESTING
Federal Authorities Requesting:
California Permits Requesting:
PERMITS REQUESTING
The following permits were selected:
State (if selected):
Other (if selected):
Are you CTC Registered?:
DRUG & ALCOHOL PROGRAM
Are you enrolled in a drug & alcohol program?
I would like to enroll in a program with Accurate Drug Services?
FUEL TAX REPORTING
I would like Road Ready to file my quarterly fuel taxes:
SERVICE FEE PRICE SHEET
IRP Account (New Account, New Fleet, Renewal)
New Account $TBD*
Renewal $ TBD*
*Based on number of trucks
IRP Supplements
Add Tractor $175.00
Duplicate Items and Corrections
Plates (IRP) $87.00
Sticker $87.00
Cab Card Corrections $87.00
Quarterly Fuel Tax Reporting
Power Units $30-84.00 per unit per quarter (based on # of months ran)*
OR, NY Monthly Tax $50.00
New Account Set Ups & Renewals-Authorities & Permits
Permit Set Ups $80.00/ each permit
EIN Application $79.00
Oregon Set Up with Bond $185.00
MC/ICC./DOT - Original Set Ups $175.00 plus $50.00 for BOC3
CA/MCP - Original Set Ups $185.00
Add Units - Permits & Filings
IFTA Permit $80.00
New Mexico $80.00
New York $80.00
Oregon $80.00
Kentucky, Arkansas $80.00
UCR $85.00 - $550.00 *based on # of trucks
2290 $85.00 - 300.00 *based on # of trucks
Duplicate & Replacement Permits $35.00
*Based on number of trucks
Misc.
Audits & Counseling $95.00 per hour
VIN Verifications $95.00
DMV Vehicle Printouts $20.00
DMV NMVITIS report $11.00
*** Federal Express, GLS and/or UPS will be mailed out at client’s expense. If you would like Road Ready Registration, Inc. to use your account number, please inform us immediately. ***
The fees listed above are for Road Ready Registration service fees only. Service fees must be paid Upon receipt for the first six months, unless otherwise negotiated. All DMV fees quoted are estimated fees only. Actual DMV fees are determined by the state.
Service fees listed above are subject to change without notice.
SERVICE AGREEMENT
This agreement is made by and between Road Ready Registration Entities, a California Corporation with it principal place of business located at 9561 PITTSBURGH AVE RANCHO CUCAMONGA, CA 91730 and with its principal office located at , .
Road Ready Registration Entities provides various Title & Registration Services, Renewals, Interstate Commercial Licensing, Permits, Fuel Tax Reporting, Authority Filings, and DOT Drug & Alcohol Services.
Now, therefore, for good and valuable consideration, the parties agree and follow:
- Article 1 (Term) – This Agreement will become effective on the date on which it is signed by a representative of the Company and the Title & Registration Services, Renewals, Interstate Commercial Licensing, Permits, Fuel Tax Reporting, Authority Filings, and DOT Drug & Alcohol Services has been completed by the Customer. This agreement shall remain in effect for one (1) year.
- Article 2 (Services) – Subject to qualifying, Road Ready Registration Entities shall provide the Customer Title & Registration Services, Renewals, Interstate Commercial Licensing, Permits, Fuel Tax Reporting, Authority Filings, and DOT Drug & Alcohol Services at the rate of agreed upon price sheet, (please see attached price sheet).
- Article 3 (Indemnification) – Road Ready Registration Entities is an independent contractor providing the Customer with Title & Registration Services, Renewals, Interstate Commercial Licensing, Permits, Fuel Tax Reporting, Authority Filings, and DOT Drug & Alcohol Services provided herein. The Customer agrees to indemnify, defend and hold Road Ready Registration, Inc., its officers, directors, agents, employees and other related parties harmless from and against any and all liabilities, damages, losses, expenses, claims, demands, suits, fines, or judgments that include reasonable attorney’s fees, costs and expenses, incidentals thereto, which may cause suffrage or may come into existence as a claim that is legally enforceable and may accrue for charges to or recoverable from any customer or customers’ client indemnitee, by reason of any claim arising out of or relating to any act or error or omission, or misconduct of Road Ready Registration Entities, its officers, directors, agents, employees or subcontractors.
- Article 4 (Force Majeure) –Road Ready Registration Entities will not be responsible or liable to the Customer for failure or delay in performance, which results from or is due to, directly or indirectly and in whole or part, any cause or circumstances beyond the reasonable control of Road Ready Registration Entities.
- Article 5 (Payment Terms) –Payment is due upon receipt of services, unless other arrangements have been made in writing. Every 30 days a letter will be generated for late payments. Any open balances over 90 days late will be subject to collection through Road Ready Registration Entities collection agency.
- Article 6 (Fixed Pricing) –No increase or decrease of fees will be automatic. A minimum of 30 days written notice is required. Road Ready Registration Entities is not responsible for any oral instructions.
- Article 7 (Applicable Law) – This Contract will be construed under the laws of the State of California.
- Article 8 (Termination and Renewal of Agreement) – If this Agreement is suspended or terminated for any reason by the Customer, the money received shall be deemed earned. It is understood by all parties and it’s employees that this agreement shall remain in effect until cancelled by either party, with a thirty (30) days written notice.
- Article 9 (Cancellation) – If the account is 90 days or older Road Ready Registration Entities can choose to cancel your account, until your account is brought current.
- Article 10 (Terms and Conditions) –The only terms and conditions that will be applicable to the interpretation of this agreement are those issued by Road Ready Registration Entities, of Rancho Cucamonga, California.
Your digital signature of this Service Agreement below indicates your acceptance of the Terms and Conditions.
***OFFICE USE ONLY***
Date Received: _________________________________________ Rep: ___________________________________________________
Customer Folder Type: Brown Manilla Purple Green
Copies Given To: _______ Office Manager _______ Accounting
***IMPORTANT: YOU MUST SIGN BELOW, THEN HIT "AGREE & SIGN" BUTTON IN BLUE CORNER***
YOUR SUBMISSION WILL NOT BE DIGITALLY SIGNED UNLESS THIS IS COMPLETED
