AMOUNT OF REQUIRED COVERAGE
Non-hazardous Property & Household Goods
$100,000 for any injury or death of one person
$300,000 for any one accident
$50,000 property damage for any one accident
$1 million or $5 million dependent upon hazard class(es)/division(s)
being transported. To determine exact liability coverage, please call
Cargo (only required for Household Goods)
$2,500 for loss or damage to property carried on any one motor vehicle.
$5,000 for loss or damage to, or aggregate of losses or damages of or to
property, occurring at any one time or place.
SECTION 5 – REGISTERED AGENT FOR SERVICE OF PROCESS IN MISSOURI
If the principal place of business is NOT in Missouri the name and address of a process agent based in Missouri where service can be made on the
business MUST be provided. This must be the name of an individual, not an organization, and the address must be a physical location, not a PO Box.
The FMCSA provides a list of some process agents on their website at www.fmcsa.dot.gov/registration/process-agents.
For corporations located in Missouri, any officer listed in Section 3C may be used as the registered agent unless another individual is specified.
SECTION 6 – REGULATORY LICENSE FEES (not required for not-for-profit corporations)
Check the box that represents if a door or window decal is needed, or if fees are paid under the Unified Carrier Registration program.
Intrastate Carriers – must purchase either door or window decals for each vehicle. Note: Window decals are for passenger service with 6 to 12
passenger capacity only.
Decals are $10 per vehicle, and payment must be received before authority is issued.
Interstate Carriers – must pay fees through the Unified Carrier Registration program and are not required to purchase or display Intrastate decals.
SECTION 7 – HAZARDOUS MATERIALS
Check the box that indicates the type of insurance required and what class and division of hazardous materials are transported. If ALL divisions
within a class are transported, check the box titled “All Divisions”.
The classes and divisions listed MUST be registered with the FMCSA. If objects powered by a flammable liquid including, but not limited to
motor vehicles are transported, Class 9 – Miscellaneous must be chosen.
The signature of the applicant is required before processing the application. If someone other than the applicant signs, proof of Power of Attorney
If requesting a transfer, a signature is required in Section 1 on page 1 and in this section before the application can be processed.
Corporate officers may sign on behalf of the corporation, and a Member or Manager of an LLC may sign on behalf of the business.
Complete Section 9-12 ONLY if box 2, 3, 4 or 5 in Section 1B are checked
SECTION 9 – VERIFICATION OF WORKERS COMPENSATION (only required for Household Goods applicants)
Check the box that represents COMPLIANT, SELF-INSURED, or EXEMPT from obtaining workers compensation coverage.
Any lapse or discontinuation of service will result in a suspension of authority.
SECTION 10 – EQUIPMENT TO BE USED
List all power units or equipment used. Be sure to indicate if the equipment will transport hazardous materials.
Household Goods Carriers – list the Licensed Weight of the vehicle.
Passenger Carriers – List the Seating Capacity of the vehicle.
SECTION 11 – STATEMENT OF RATES (only required for Passenger applicants)
Provide a description of how rates will be charged.
Household Good Carriers – must complete a formal tariff AFTER authority has been granted, but before operations begin. The tariff must be
available for review at each terminal.
Passenger-Other-Than-Charter Carriers – intrastate carriers must file a formal tariff with MoDOT Motor Carrier Services BEFORE the issuance of
authority. Interstate Passenger-Other-Than-Charter carriers are NOT required to file a tariff with MoDOT.
SECTION 12 – FINANCIAL FITNESS
Fill out the appropriate information as indicated below if applying for Household Goods, Passenger Other than Charter, or Passenger Charter
authority with a seating capacity of less than 16 passengers.
Sole Proprietor or Partnership: complete column A. Partnerships must also complete a balance sheet for each partner.
Limited Liability Company or Corporation: complete columns A & B.
This section is not required for Property, Passenger Other than Charter as a Not-for-Profit Corporation, or Passenger in Charter authority with a
seating capacity of 16 or more passengers.