MISSOURI DEPARTMENT OF TRANSPORTATION
MOTOR CARRIER SERVICES
PHONE: (800) 877-8499 FAX: (573) 751-7408
www.modot.org/mcs
ESCROW DEPOSIT
THIS FORM MUST BE COMPLETED AND ACCOMPANY EACH DEPOSIT
MAIL THIS FORM TO: MISSOURI DEPARTMENT OF TRANSPORTATION
MOTOR CARRIER SERVICES
P.O. BOX 270
JEFFERSON CITY, MO 65102-0270
STREET ADDRESS 830 MoDOT DR.
JEFFERSON CITY, MO 65101
COMPLETE THE FOLLOWING TO MAKE A DEPOSIT
TO YOUR CURRENT ESCROW ACCOUNT
(Use only escrow account numbers issued after September 2005)
Escrow Account
Number
-
9
Deposit
Amount
$
USDOT Number
Legal Name
Mailing Address
City
State
Zip Code
Contact Person
Telephone Number
TO MAKE A DEPOSIT WITH A DEBIT OR CREDIT CARD CALL 1-800-877-8499
ALL CHECKS ARE TO BE MADE PAYABLE TO:
MISSOURI DIRECTOR OF REVENUE - CREDIT STATE ROAD FUND
(Your cancelled check is your receipt)
Refer to the Oversize and Overweight Permit Regulations Book for information regarding escrow accounts.
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome