1
MISSOURI DEPARTMENT OF TRANSPORTATION
PHONE: 573.751.3358
MOTOR CARRIER SERVICES
FAX: 573.522.6708
PO BOX 270, 830 MODOT DRIVE, JEFFERSON CITY, MO 65102-0270
TOLL FREE: 866.831.6277 Option 3
FORM WT-2 SUPPLEMENTAL PERMIT CERTIFICATE FOR TRANSPORTING WASTE TIRES
GENERAL INFORMATION:
NAME OF CARRIER
USDOT NO
TRADE OR DBA (DOING BUSINESS AS) NAME
PHONE NO
PRINCIPAL PLACE OF BUSINESS ADDRESS (Not a PO Box)
FAX NO
EMAIL ADDRESS
CHECK ONLY ONE:
ADDING POWER UNITS TRANSPORTING WASTE TIRES.
REPLACING A POWER UNIT TRANSPORTING WASTE TIRES.
List new vehicle(s) below and the unit number of vehicle being replaced. Mail a copy of bill of sale or Proof of Loss to issue this
replacement permit for more than 60 days.
LIST OF VEHICLE(S) BEING ADDED OR REPLACED:
Make
Type
(Tractor,
Truck, Box
Truck, etc)
Year
License
Plate
STATE
License
Plate
NUMBER
Company
Unit Number
Replaces Unit
Number
Gross
Vehicle
Weight
Rating
(GVWR)
Licensed Weight
of Vehicle
(Missouri Weight
Categories)*
* NOTE: Missouri Licensed Weight Categories are 6,000, 12,000, 18,000, 24,000, 26,000, 30,000, 36,000, 42,000, 48,000, 54,000, 60,010, 66,000, 73,280, 78,000,
or 80,000 pounds. If your licensed vehicle weight is different from one of these numbers round up to the nearest weight listed.
SIGNATURE
APPLICANT(S) NAME PRINTED
APPLICANT(S) SIGNATURE
TITLE
DATE
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
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