Fillable General Permit Facsimile Application (Texas Department of Motor Vehicles)

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General Permit Facsimile Application (Texas Department of Motor Vehicles)

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  • 12 check-boxes
  • 136 other fields

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File type: PDF

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General Permit Facsimile Application
Instructions
Please fill out form completely and legibly.
For assistance please call 1-800-299-1700.
Form MCD-106 (Rev. 09/2020)
Instruction Page
Helpful Hints:
1. Include the proper highway signage for each highway you wish to travel.
2. Make sure each applicable field is completed. Incomplete fields may result in the delay of your permit being processed.
3. Illegible applications may result in errors in your permit. To ensure information is permitted properly, typing this form is
encouraged.
1. Prior to being issued a permit, applicant must comply with one of the following:
· TxDMV Motor Carrier Registration, or
· Federal Unified Carrier Registration (UCR), or
· Have a permit surety bond in the amount of $10,000 on file with TxDMV (Form MCD-439)
2. Register vehicles under the provisions of Texas Transportation Code, Chapter 502.
Note: If your oversize/overweight vehicle or vehicle combination requires a Temporary Permit
(Registration), then you must obtain this prior to submitting this application. Please visit
www.TxDMV.gov, select “Temporary Permits” under the "Motorist" heading.
3. Agree to Attest Statements (located in Load Information section):
a. I attest that the load is non-divisible: A load or vehicle that cannot be separated into smaller loads or
vehicles without compromising the intended use of the vehicle (making it unable to perform the
function for which it was intended), destroying the value of the load or vehicle (making it unusable for its
intended purpose), or requiring more than eight hours of work using appropriate equipment to
dismantle (permittee has the burden of proof as the number of workhours required to dismantle the
load).
b. I attest that hauling multiple items does not create an over-dimension: When a permitted commodity
creates a single over-dimension, two or more commodities may be hauled as one permit load, provided
legal axle weight and gross weight are not exceeded, and provided an over-dimension of width, length
or height is not created or made greater by the additional commodities.
4. Specify Dimensions and Weight: Dimensions/weight should include truck and trailer with the commodity
loaded. The overall length should include all overhangs. Dimensions should be submitted in feet and
inches. Weights should be submitted in pounds.
For faster processing, order your permit online through the Texas Permitting & Routing Optimization System
(TxPROS) at TxPROS.TxDMV.gov.
General Permit Facsimile Application
Order your permit online at www.txdmv.gov
This application must be filled out in its entirety prior to a permit being issued
Fax Application to: (512) 465-4248
Page 1 of 2
Form MCD-106 (Rev. 09/2020)
Company Information
Company Name
Customer Account Number
Mailing Address City State Zip
Contact Person Phone Number
Fax Number
Email Address
TxDMV Number or
Number
Current Texas Surety Bond on file with TxDMV
Current Unified Carrier Registration (UCR) with current insurance or
USDOT Number
I attest to having one of the following:
Permit/Wire Service (if applicable)
Permit/Wire Service Name
Contact Person
Permit Start Date
Vehicle Information
Truck Year VIN License Plate Number State
Note: If the truck has a temporary permit (registration),
provide the following information:
Issuing StateExpiration DateTemporary Permit Number
Truck Make
Load Information
Load Description
Maximum Width
Maximum Height Maximum Length
Rear OverhangFront Overhang
Route using actual underclearance of
Route around underclearance restrictions.
Industry Type (ex. general construction, oil and gas, implements of husbandry, etc.)
I attest that hauling multiple items does not create an overdimension.I attest that the load is nondivisible.
Select one of the following statements:
Trailer Length
All dimensions must be numerical values (do not write "legal" for a dimension)
Weight Information
1 2 3 4 5 6 7
8
9 10 11 12 13 14
(Required when exceeding legal axle weights or 80,000 pounds gross weight.)
Weight (x1000)
Number of Tires
Tire Tread Width
Gauge
Steerable or Fixed (S/F)
Axle Spacing (Feet Only)
For more information on General Permits, visit our website at www.TxDMV.gov. For comments concerning the application process call (800) 299-1700 or
email MCD_SizeWeight@TxDMV.gov.
The Texas Department of Motor Vehicles maintains the information collected through this form. With few exceptions, you are entitled on request to be
informed about the information that we collect about you. Under Sections 552.021 and 552.023 of the Government Code, you also are entitled to receive
and review this information. Under Section 559.004 of the Government Code, you are also entitled to have us correct erroneous information.
Payment Method
MasterCard, Visa, Discover or American Express*
Account Number
*A service charge of 25 cents per permit plus 2.25 percent of
the total fee amount will be added to all credit card
transactions.
Escrow
Permit Account Card (PAC)
Credit Card Expiration Date
/
Annual Envelope Permit (AEV) (optional)
Yes
No
Use an AEV in conjunction with this permit?
If yes, permit number:
General Permit Facsimile Application cont.
Page 2 of 2
Form MCD-106 (Rev. 09/2020)
Route Information
Border Crossing (include the state and the highway, i.e., NM Line IH40)
Width Height Length
Gross Weight
Intersection (provide two cross-streets)
Empty Trip to Get Load (optional)
Empty
Origin
Select One
Empty
Dimensions
Border Crossing (include the state and the highway, i.e., NM Line IH40)
Intersection (provide two cross-streets)
Loaded
Origin
Select One
Requested
Route
Border Crossing (include the state and the highway, i.e., NM Line IH40)
Intersection (provide two cross-streets)
Destination
Select One
Border Crossing (include the state and the highway, i.e., NM Line IH40)
Width Height Length
Gross Weight
Intersection (provide two cross-streets)
Empty Trip to Return to Yard (optional)
Empty
Destination
Select One
Empty
Dimensions
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General Permit Facsimile Application (Texas Department of Motor Vehicles)

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Completed 9 January 2021

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