Mileage Permit Facsimile Application
Order your permit only 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
Form MCD-106M (Rev. 07/19) Page 1 of 2
Company Information
Company Name
Customer Account Number
Mailing Address City State Zip
Contact Person Phone Number
Fax Number
Email Address
Permit Start Date
Unit Information
Unit Year VIN License Plate Number StateUnit Make
Maximum Width
Maximum Height Maximum Length
All dimensions must be numerical values (do not write "legal" for a dimension)
Unit/Rig Number
Trailer Year VIN License Plate Number StateTrailer Make
Unit/Rig Number
Well Servicing Unit (Self-Propelled or Trailer Mounted)
Gross Weight
1 2 3 4 5 6 7 8 9 10
”’ ”’”’”’”’”’”’”’”’
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Axle Spacing
Weight (x1000)
Number of Tires
Tire Tread Width
Gauge
Steerable or Fixed (S/F)
Axle spacings and gauge per axle are expressed in feet and inches and
measured to the nearest inch. Axle spacings are measured from center of axle
to center of axle. The gauge per axle is the distance from the center of the dual
wheels on one side of the unit measured across to the center of the dual
wheels on the opposite side of the unit. On a unit with only two tires per axle,
the gauge per axle is the distance from the center of a tire on one side of the
unit measured across to the center of the tire on the other side of the unit.
Weight Information
Crane (Self-Propelled or Trailer Mounted)
The Texas Department of Motor Vehicles maintains the information collected through this form. With few exceptions, you are entitled upon request to be
informed about the information that we collect about you. Under §§552.021, 552.023 and 559.004 of the Texas Government Code, you are entitled to
receive and review the information, and to have us correct erroneous information.
Industry Type (examples: oil and gas, general construction, road construction, telecommunications and electric utility, wind energy)
