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Fillable Printable Dot Number Determination/Disclosure

Fillable Printable Dot Number Determination/Disclosure

Dot Number Determination/Disclosure

Dot Number Determination/Disclosure

DOT Number Determination/ Disclosure
Use this form to determine if your vehicle needs a U.S. Department of Transportation (DOT) number to register. DOT
numbers are required for certain vehicles used for commercial purposes, defined as promoting, selling, or distributing
products or services.Take or mail this completed form to
any vehicle licensing office with your vehicle renewal or title
application. If you have questions, call (360) 902-3770, Option 5.
Section 1 – Vehicle
1. Is your vehicle designed to transport 16 or more passengers, including the driver? ............... Yes No
2. Does your vehicle have a GVWR of 16,001 pounds or more? ................................ Yes No
3. If your vehicle has a GVWR of 6,000 pounds or more, do you tow a trailer with a GVWR
of 10,001 pounds or more? ........................................................... Yes No
4. Is your vehicle used to transport hazardous materials that require a DOT placard? ............... Yes No
5. Is your vehicle an auto transport, charter party carrier, excursion service carrier, solid waste
collection truck, or used to transport household goods? .................................... Yes No
6. Is your vehicle used as a private school bus? ............................................. Yes No
If you answered “Yes” to any of the questions above, you must provide a DOT number to register the vehicle. Complete
sections 2 and 3.
7. Is your vehicle for personal use only? ................................................... Yes No
If you answered “Yes”, a DOT number is not required. Go to section 3.
Section 2 – Carrier
If operating under your own DOT number, you are the Carrier Responsible for Safety (CRS). If you operate under a lease
agreement you are under someone else’s DOT number and they are the CRS.
I operate under my own DOT number.
My DOT number Federal taxpayer ID number
I operate under short-term lease agreements that expire in less than 30 days.
Registered owner DOT number Federal taxpayer ID number
I operate under a long-term lease agreement that will not expire in 30 days. Attach a copy of the lease agreement or
equivalent (see page 2).
Registered owner DOT number Federal taxpayer ID number
Lessor name
Lessor DOT number Lessor federal taxpayer ID number
Will your lease expire within the vehicle registration period? ................................. Yes No
Section 3 – Registered owner/Vehicle identification
Name or business name
Address
City State ZIP code
Vehicle Identification Number (VIN) Year Make Model
Gross vehicle weight rating (GVWR) License plate number
TD-420-012 (R/6/16)WAE Page 1 of 2
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To get a DOT number, you must complete the Federal Motor Carrier Safety Administration
form MCS-150.You can apply online at www.fmcsa.dot.gov or call (360) 596-3810 to have a
form mailed to you.
Gross Vehicle Weight Rating (GVWR) is the maximum loaded weight of the vehicle
determined by the manufacturer.
The GVWR can be found in several places:
•Alabelontheinsideframeofthedriver’sdoor
•Intheenginecompartment
•Intheowner’smanualorsalesbrochure
•Fortrailers,towardthefrontofthetrailerontheleftside
Carrier Responsible for Safety (CRS) is the person or company responsible for the safety
of a vehicle or group of vehicles.
Federal taxpayer Identification number is your federal Employer Identification Number
(EIN) or Social Security number (SSN). If you do not have an EIN you must provide your SSN.
We cannot accept your Unified Business Identifier number.
Operating under your own DOT number
If you are the owner of the vehicle and will not be operating under a long-term lease agreement, you will be operating
under your own DOT number and you are the CRS.
Operating under someone else’s DOT number
If you have entered into a lease agreement to operate your vehicle for an individual or business, you will be operating under
someone else’s DOT number and they are the CRS.You are required to provide a copy of the lease agreement, a certification
of lease, or a letter from the lessor when you register your vehicle.
The certification of lease or the letter on company letterhead must include the following:
•Adescriptionofthelease.Forexample:
John Doe, XYZ Trucking Company, is presently leased to ABC Trucking Company.
Mr. Doe will be operating under our DOT number, , during the term of the lease.
Our EIN (or SSN) is .
•Thetermoftheleaseinmonths
•Thefullnameandaddressofthelessorandlessee
•Theyear,make,model,andVINnumberofthevehicle
•Lessorcontactnameanddaytimetelephonenumber
Short-term lease is a lease agreement between two parties that is expected to expire within 30 days of the date of the
agreement. In a short-term lease, you are required to have a Carrier DOT number to register your vehicle. A copy of the
lease agreement should identify the lessor that is the CRS, must be carried by the driver while operating the vehicle, and
must be provided to law enforcement when requested.
Long-term lease is a lease agreement between two parties that will not expire within 30 days of the date of the
agreement.To register a vehicle that is operated under a long-term lease, you must provide:
•YourDOTandfederaltaxIDnumber(registeredowner)
•Lessor’sDOTandfederaltaxIDnumber(CRS)
•Acopyoftheleaseagreement,certicateoflease,orletterfromthelessor
When the lease expires or is terminated, you must go to any vehicle licensing office to notify the Department of Licensing.
TD-420-012 (R/6/16)WAE Page 2 of 2
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