Name of Person Completing this Order {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Company Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
DBA (if applicable) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
U.S. DOT Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
MC/MX Number (if applicable) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Federal Tax ID Number (FEIN) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Social Security Number (SSN) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Physical Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Mailing Address (if different than physicall address) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Vehicle Types
Vehicle Type {binding ItemNumber}
Select the type of vehicle {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Number of this type of vehicles in your fleet? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Maximum number of passengers: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
What type of "other" vehicle? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
If you have more vehicles of other type click the ADD VEHICLE TYPE button to add more vehicles
{ binding firstError.message }
If you do not operate any trailers please indicate "0".
Do not leave this field blank.
Number of Trailers {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Enter the number of Hazmat Cargo Trailers: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Total number of drivers: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
From the Total, how many have a CDL license? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
ESTIMATED MILEAGE IN 2020
Total miles travelled in 2020 (Estimated between January - December) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Note, you can estimate this number. (permitted margin of error: nearest 10,000 miles).Insert and format text, links, and images here.
Cargo Carried {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
You are deemed an INTERSTATE carrier if:
1) your vehicle crosses state lines; and/or,
2) your cargo originates from out of state or is transported out of state
(*see the bill of lading for destination/origin of cargo)
Special notes / additional information: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
SELECT ALL APPLICABLE OPTIONS TO YOUR COMPANY:
The following questions pertain to the 2019-2020 period:
{ binding firstError.message }
Activity (Offered or transported in commerce) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Hazardous Materials (Carrier or Shipper) - CHECK ALL THAT APPLY
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
HazMat Code/UN: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Transporting hazardous materials requires a certificate of registration in addition to the hazardous materials permit. If you did not have a certificate of registration for this year please check the box below to obtain one.
Please note that unlike the hazmat permits, certificate of registration must be renewed every year. Whereas, hazmat permit updates must be filed every two years.
Yes, I'd like to obtain the Certificate of Registration {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Please note that unlike the hazmat permits, certificate of registration must be renewed every year. Whereas, hazmat permit updates must be filed every two years.
HAZMAT CERTIFICATE OF REGISTRATION
{ binding firstError.message }
Railroad Alphabetic Code (if applicable) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
The North American Industry Classification System (NAICS) Code for Primariy Business Activity is a 6-digit code. It is required to file the HazMat Registration Statement. If you do not know your code it can be verified for you with the NAICS for an additional charge.
NAICS code (Business Category - 6 digits) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
NAICS verification: Describe your type of business (cargo, operations): {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Certificate of Registration Processing Fee {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
HazMat Registration Due Upon Processing by the U.S. DOT:
Small Business / Non Profit:
includes the $25 DOT processing fee
2020-2021 (1 year) = $275
2020-2022 (2 years) = $525
2020-2023 (3 years) = $725
Not Small Business:
includes the $25 DOT processing fee
2020-2021 (1 year) = $2,600
2020-2022 (2 years) = $5,175
2020-2023 (3 years) = $7,750
Am I 'Small Business' or 'Not Small Business' ?
The NAICS code (above) determines your business type. Your application will be filed if your NAICS code is Small Business. If it is determined that your business is Not Small Business, you WILL BE CONTACTED prior to filing you application. All filing fees over $1,000 will result in an agent contacting your company to confirm your application prior to processing this application with the U.S. DOT.
Pay by Credit Card
Name on Credit Card {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Credit Card Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Expiration Month {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Expiration Year {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
CVC code (back of credit card) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Billing Zip Code {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Pay by Bank Account
Name of Bank Account Owner {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Routing Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Account Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Verify Account Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
For Hazmat Permit Renewals it is highly recommended to provide and to sign your application with your U.S. DOT PIN, in order to safeguard against errors and to file your application in timely fashion.
If you do not know your U.S. DOT PIN, please call 1-240-54-0881 and an agent will be able to assist you in resetting it.
How would you like to sign the application?
PIN NUMBER SIGNATURE
DOT PIN Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
U.S. DOT PIN Number.
You have selected to sign the Biennial Update application using your U.S. DOT PIN number. If you do not know your PIN number or if your PIN number is incorrect, please select a different signing option from the drop down menu.
Please note that the DOT PIN number is 8 characters long and it comes in the following format: number-letter-number-number-letter-letter-number-letter.
Example: 1L34UX3P
{ binding firstError.message }
E-SIGNATURE
Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
SEND A SIGNATURE BY EMAIL OR TEXT
INSTRUCTIONS:
1. Sign your name on a white piece of paper using a black pen or black marker
2. Write your DOT number below or next to your signature
3. Scan the signature or take a picture of it with your phone
4a. Email the signature to signature@hoffenmer.com
or
4b. Text/SMS the signature to (202) 856-6065
Note: this number can only receive text messages. To speak with an agent please call (240) 544-0881
{ binding firstError.message }
REQUEST A FORM TO SIGN
You have selected to sign a manual form.
When you submit this application it will be processed by an agent assigned to your case. The processed application will be emailed to you requesting a signature. Please sign that application and return it to your agent by email or fax (return instructions will be provided in an email from your agent). Please continue to submit this application (below).
Note: manual form submission carries an extra charge due to further processing that is not required when using a DOT PIN number.
{ binding firstError.message }
8: PAYMENT AND SUBMISSION
Processing, Filing and Confirmation Fees
Hazmat Permit Registration Filing Fee {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Confirmation by email: an emailing stating that your filing has been accepted by the U.S. DOT
Snapshot of your company in the U.S. DOT Database (displays your last filing and company standing; may be used as proof of filing)
Certificate of Filing is a printed document with an confirmation ID number, your filing date and an expiration date indicating your next filing. It also includes a snapshot of your company from the DOT Database. Certificate ID cards are optional (not required) and can be carried in your vehicle(s) as proof of filing. The certificate comes with an insurance against roadside violations (all roadside violations issued to your company per FMCSR 390.201 or FMCSR 390.19 will be challenged at no charge to you until the expiration of the certificate).
How many ID Cards would you like to request ($8) ? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
ID Cards Total: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Expedited processing is recommended if you need your application to be processed within 24 hours (and most times within the same business day). Situations that require expedited filings include: suspsended DOT numbers, insurance renewals, or last-minute filings. Note: a filing may be delayed if your application is missing required information. In such case, an agent will contact you within 24 hours.
{ binding firstError.message }
Terms and Conditions
By accepting these Terms and Conditions you agree to the following general terms and conditions:
- All information herein enclosed is accurate and reflects the current status of your company, to the best of your knowledge
- The Processor (Hoffenmer Federal Applications Processor) will not be held responsible for any erroneous information provided in the herein form. All data will be submitted to the U.S. Department of Transportation as is provided in this application. The Processor will, to the best of its abilities, attempt to catch any inconsistencies and/or erronously appearing information and contact you to verify its validity
REFUNDS
- All application submissions are final and once processed refunds will not be issued. Refunds will be accepted if requested within 48 hours of filing AND if an application has not yet been processed/submitted with the U.S. DOT/FMCSA.
For the full T&C and Privacy Policy visit: https://www.hoffenmer.com/terms_conditions.html
I AGREE TO THE TERMS AND CONDITIONS {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Today's Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
SIGNATURE (TYPE YOUR NAME) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }