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Form 2290/Heavy Highway Vehicle Usage Tax

$675.00

Under UCR 49 USC 14505a, any company who travels, or sends their drivers over state lines for work-related purposes, must pay this yearly state tax. Only for 1 CMV, additional vehicles must be purchased separately. Late fees are not included.

LEGAL BUSINESS NAME:

Trade Name:

EIN:

Business Type:

Principle Address:

Principle Address 2:

Principle City:

Principle State:

Principle Zip:

Principle Country:

Is Mailing Address as Principle Address?:

Mailing Address:

Mailing Address 2:

Mailing City 2:

Mailing State:

Mailing Zip:

Mailing Country:

Contact First Name:

Contact Last Name:

Phone Number:

Contact Cell Number:

Fax Number:

Email:

Vehicle Identification Number (VIN)

Logging Vehicle

ALL MOTOR PASSENGER CARRIER APPLICANTS MUST CERTIFY AS FOLLOWS

I certify that I am familiar with the Federal Motor Carrier Safety Regulations and/or Federal Hazardous Materials Regulations. Under penalties of perjury, I declare that the information entered on this report is, to the best of my knowledge and belief, true, correct, and complete.

CERTIFICATION STATEMENT

I certify I am the owner or designated representative of the company for which I am purchasing this service(s). Therefore, I hereby give HBT Dispatch Services, LLC permission to act on my behalf in performing the duties I have purchased. I also hereby certify that the above statements are true and correct to the best of my knowledge. I understand my state might require me to sign a state specific power of attorney in order for HBT Dispatch Services, LLC to perform activities on a state level. I will provide any additional information within a timely manner (48HRS of it being requested) & understand HBT Dispatch Services, LLC is not liable for any late fees. Any correspondences will be through email (support@hbtdispatchservices). I understand HBT Dispatch Services, LLC does not conduct business via any social media platforms. If I do not receive an email with an update on my filings, I will check my spam or junk folder BEFORE contacting the office. I understand there is a no refund policy.

Name

Title

Date

SIGNATURE

Category: Back Office Support

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Price: $675.00 p/Vehicle (Does NOT include taxes and late fees)
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12774 Wisteria Dr, Suite #2844

(888) 343-5070

Mon - Fri: 9:00 - 6:00 EST

Form 2290/Heavy Highway Vehicle Usage Tax

ALL MOTOR PASSENGER CARRIER APPLICANTS MUST CERTIFY AS FOLLOWS

CERTIFICATION STATEMENT

Description

Reviews

12774 Wisteria Dr, Suite #2844

(888) 343-5070

Mon - Fri: 9:00 - 6:00 EST

Form 2290/Heavy Highway Vehicle Usage Tax

ALL MOTOR PASSENGER CARRIER APPLICANTS MUST CERTIFY AS FOLLOWS

CERTIFICATION STATEMENT

Description

Reviews

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