SHIPPER'S CERTIFICATE OF WEIGHT
This Shipper's Certificate of Weight must be given to the motor carrier (or person) transporting a shipment
before the motor carrier (or person) applies for an oversize/overweight permit.* This certification remains
valid even when a permit is not purchased.
Under penalty of perjury, I, , an agent of the above-named shipper,
certify that I am authorized to make this certification on behalf of the shipper listed above and I certify that
the information provided on this certificate of weight is true and correct. Additionally, I agree that the
shipper will submit any information requested by the Texas Department of Motor Vehicles that confirms
the weight of the cargo in question. I also understand that any misrepresentation of cargo weight or any
other information on this certification and/or the attachments, if any, can result in administrative penalties
under Transportation Code §623.272.
Shipper:
Name
Address City State ZIP
Telephone
Motor Carrier:
Name
Cargo:
Description of Cargo
Maximum Cargo Weight:
* If the shipment consists of multiple loads, parts and pieces, the attached itemized list of (# of )
page(s) is incorporated by reference as if written and copied herein. The listing must indicate the weight of
each piece and must be signed and dated on each page by the same person making this certification.
Place and date of Certification
Signature
TitlePrinted name of certifying agent
Certifying Agent:
pounds
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 information about you that is incorrect.
Form 2280 (Rev. 07/17)
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