Federal Applications Processor
Hoffenmer
Ph: (240) 544-0955
Chat: dotsos.us

Name of Person Completing This Application: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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FILING STATUS NOTIFICATIONS:

In an effort to provide status updates of your FMCSA Clearinghouse Registration filing, we require a working email address and / or cell phone number where you'll receive filing notifications.
 
This will keep you informed whether your application is pending or it has been processed by the US DOT. 

Select how would you like to receive notifications: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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For Status Notifications

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For Status Notifications

 

 

Driver's Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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To ensure prompt request turn-around, please check your CDL number for accuracy.

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Physical Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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In addition to establishing an account, the fee includes an annual maintaintenance of the account, conducting required queries and staying informed by notification of when queries are due as well as communicating query requests with new and current employees per FMCSA.

 

 

To Expedite the registration select 'Yes' below.

Expedited requests are completed within 24 hours.
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SIGNATURE & AGREEMENT

 

TERMS & CONDITIONS

 

By accepting these Terms and Conditions you agree to the following:

 

GENERAL

- 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.

RECURRING SERVICES

Recurring services, also known as annual services (ex. Maintenance of Clearinghouse Portal) require renewal and are subject to annual charge. Initial Clearinghouse Registration includes one year maintenance. When it is time to renew this service the  agent with the Federal Applications Processor will reach out to the applicant's email on file to complete the renewal for the next period.
 

 

 

 

I HAVE READ AND AGREE TO CLEARINGHOUSE REGISTRATION TERMS AND CONDITIONS {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Today's Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
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Use your computer mouse to sign, or open the application on touch-screen device to sign with your finger.

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LEAVE BLANK. FOR INTERNAL USE ONLY.

{~ Payment_Block_Label}

{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}---
{{ Cognito.resources['payment-amount-due'] + ":" }} {binding displayValue}

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{{ Cognito.resources['order-billing-info-header'] }}

{binding BillingName}
{binding EmailAddress}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{{ Cognito.resources['order-billing-info-header'] }}

{binding BillingName}
{binding EmailAddress}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}

 

 

Federal Applications Processor
Hoffenmer
Ph: (240) 544-0955
Chat: dotsos.us

Name of Person Completing This Application: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

FILING STATUS NOTIFICATIONS:

In an effort to provide status updates of your FMCSA Clearinghouse Registration filing, we require a working email address and / or cell phone number where you'll receive filing notifications.
 
This will keep you informed whether your application is pending or it has been processed by the US DOT. 

Select how would you like to receive notifications: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Enter Cell Phone Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Enter Email Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

 

Driver's Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Driver License Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Re-enter Driver License Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Select Driver License Country {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Select Driver License State {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Date of Birth {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Physical Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Contact Phone Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

 

Clearinghouse Registration Processing Fee: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

In addition to establishing an account, the fee includes an annual maintaintenance of the account, conducting required queries and staying informed by notification of when queries are due as well as communicating query requests with new and current employees per FMCSA.

 

 

To Expedite the registration select 'Yes' below.

Expedited requests are completed within 24 hours.
Yes - Expedite ($50) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

 

 

 

SIGNATURE & AGREEMENT

 

TERMS & CONDITIONS

 

By accepting these Terms and Conditions you agree to the following:

 

GENERAL

- 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.

RECURRING SERVICES

Recurring services, also known as annual services (ex. Maintenance of Clearinghouse Portal) require renewal and are subject to annual charge. Initial Clearinghouse Registration includes one year maintenance. When it is time to renew this service the  agent with the Federal Applications Processor will reach out to the applicant's email on file to complete the renewal for the next period.
 

 

 

 

I HAVE READ AND AGREE TO CLEARINGHOUSE REGISTRATION TERMS AND CONDITIONS {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Today's Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Signature Only {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Signature (Type your name) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

 

 

 

Additional Comments: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Asst Agent {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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