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Preferred Hauler Application
Applicant Name
Company Name
DOT Number
Phone Number
Email Address
Do you currently stand in full compliance with DOT/Other operating authorities?
Yes
No
Are you now or in the future planning on working direct for any other client(s)?
Yes
No
How many trucks do you currently have?
How many cited accidents have you had in the last 3 years?
How many years have you been in operation?
Comments on why you would like to join our program
Signature (type your name)
Date
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