Fillable VIRGINIA SUPERLOAD SINGLE TRIP HAULING PERMIT APPLICATION (Virginia Department of Motor Vehicles)

Fill Online, Printable, Fillable, Blank VIRGINIA SUPERLOAD SINGLE TRIP HAULING PERMIT APPLICATION (Virginia Department of Motor Vehicles) Form

Use Fill to complete blank online VIRGINIA DEPARTMENT OF MOTOR VEHICLES pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

VIRGINIA SUPERLOAD SINGLE TRIP HAULING PERMIT APPLICATION (Virginia Department of Motor Vehicles)

On average this form takes 30 minutes to complete

The VIRGINIA SUPERLOAD SINGLE TRIP HAULING PERMIT APPLICATION (Virginia Department of Motor Vehicles) form is 2 pages long and contains:

  • 0 signatures
  • 14 check-boxes
  • 112 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your Virginia Department of Motor Vehicles forms online.

BROWSE VIRGINIA DEPARTMENT OF MOTOR VEHICLES FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
HP 400 (10/27/2020)
ZIP CODE
ID NUMBER (VAHPS ID, FEIN, OR SSN) GOVERNMENT MOVE (check one) CONTACT PERSON NAME
NAME (last) (first) (mi) (suffix) TELEPHONE NUMBER
MAILING ADDRESS FAX NUMBER
P. O. BOX, SUITE NUMBER (if applicable) EMAIL
CITY STATE VA JURISDICTION (county or city—VA only) COUNTRY
COMMODITY AND VEHICLE
COMPANY NAME
Yes No (must provide overhang width)
None
OVERALL DIMENSIONS/SIDE OVERHANG
HEIGHT
______ feet ______ inches
WIDTH
______ feet ______ inches
Is the overhang evenly distributed across the left and right sides of the transporter?
WIDTH OVERHANG
LEFT ______ feet ______ inches RIGHT ______ feet ______ inches
LENGTH
______ feet ______ inches
LENGTH OVERHANG
FRONT ______ feet ______ inches REAR ______ feet ______ inches
SELF-PROPELLED CRANE
Width outside of left tire to outside of
right tire.
WIDTH _____ feet _____ inches
VEHICLE AND LOAD SIDE OVERHANG
AXLE WEIGHT AND SPACINGS
GROSS WEIGHT
pounds
NUMBER OF AXLES
AXLE 1 2 3 4 5 6 7 8 9
WEIGHT
______ lbs ______ lbs ______ lbs ______ lbs ______ lbs ______ lbs ______ lbs ______ lbs ______ lbs
DISTANCE
(between axles)
___ ft ___ in ___ ft ___ in ___ ft ___ in ___ ft ___ in ___ ft ___ in ___ ft ___ in ___ ft ___ in___ ft ___ in
LICENSED LEGAL WEIGHT
CRANE MAKE AND MODEL (if applicable)ITEM TO BE MOVED TRANSPORT METHOD (check one)
VEHICLE ID LOCATIONHAZARDOUS LICENSE PLATE NUMBER ISSUING STATE VIN/SERIAL NUMBER (last 5 digits)
Federal State Local
Haul Tow Drive
See instructions above for configurations exceeding 9 axles
Yes
No
Truck/Trailer Combination Straight Truck
VIRGINIA SUPERLOAD SINGLE TRIP
HAULING PERMIT APPLICATION
Purpose: Use this form to apply for a superload single trip hauling permit. See
additional instructions on page 3 of this application.
Instructions: Mail or fax this form to the address or fax number above. Use the Virginia
Hauling Permit Addendum Additional Axle (form HP 403) for configuration
exceeding 9 axles. The form is available online at
http://www.dmv.virginia.gov/webdoc/pdf/hp403.pdf.
REQUESTED MOVEMENT DATE (mm/dd/yyyy) (subject to approval)
SHIPPER (Hauling or Transport Company)
Telephone: (804) 786-2787 ● Fax: (804) 367-1003
DMV USE ONLY
RECEIVED DATE (mm/dd/yyyy) REFERENCE NUMBER
CHECK NUMBER CHECK AMOUNT
( )
( )
HP 400 (10/27/2020)
/
State Abbreviation
State Line
N S E W
on route
My DIRECTION will be (check one):
I am STARTING at (check appropriate box):
Provide additional starting point information ONLY if starting within Virginia.
miles
The starting point is
from starting address
ROUTE REQUESTED
City
City Name
/
County Name
County
N S E W
of route
/
State Abbreviation
State Line
N S E W
on route
My DIRECTION will be (check one):
I am ENDING at (check appropriate box):
Provide additional ending point information ONLY if ending within Virginia.
miles
The ending point is
to ending address
City
City Name
/
County Name
County
N S E W
of route
ROUTE INFORMATION
AUTHORIZED REPRESENTATIVE NAME (print)
AUTHORIZED REPRESENTATIVE SIGNATURE
CERTIFICATION
My signature below certifies that I understand no amendments will be made to a Virginia Hauling Permit once it is issued.
I further certify and affirm that all information presented in this form is true and correct, that any documents I have presented to DMV are genuine, and that the
information included in all supporting documentation is true and accurate. I make this certification and affirmation under penalty of perjury and I understand
that knowingly making a false statement or representation on this form is a criminal violation.
DATE (mm/dd/yyyy)
Prepared by permit service company (PSC)
PSC NAME
TELEPHONE NUMBER
PSC (VAHPS OR SHIPPER FEDERAL ID, FEIN, SSN)
FAX
DELIVERY (For current pricing, refer to Virginia hauling permit price list available on our website.)
DELIVERY (check one) (NOTE: For payment and delivery information please refer to the instructions on page 3 of this application.)
USPS
FAX
Page 2
PERMIT SERVICE COMPANY INFORMATION
( )
( )
HP 400 (10/27/2020)
Page 3
Requested Movement Date — Date you wish the permit to start.
SHIPPER
New Shipper Location — Check if this shipper has not been previously issued a permit in Virginia Automated Hauling Permit System (VAHPS) or if it is an
additional location for this shipper.
Shipper Address Change — Check if this application records an address change.
ID Number — If the shipper has a VAHPS ID, enter it here. Otherwise enter the shipper's federal employer identification number (FEIN) or social security
number (SSN).
Government Move — Choose federal, state, or local if this permit is being ordered to conduct a government move.
Contact Person Name — Name of the person responsible for the permit. (Contact person name will be displayed on the permit document.)
Company Name — Name of the shipper.
Name — If the shipper is a person, complete name first, last, middle initial, and suffix name box.
Telephone Number — Phone number for the contact person displayed on the permit document.
Mailing Address — Mailing address for the shipper.
Fax Number — Fax number of the shipper.
P. O. Box, Suite Number — Post office box number and/or suite number if applicable.
Email — Email address of the contact person.
City — City where the shipper is located.
State — State where the shipper is located.
Zip Code — Postal zip code where the shipper is located.
VA Jurisdiction — County or city where shipper is located (for Virginia shippers only).
Country — Country in which the shipper is located.
COMMODITY AND VEHICLE
Item to be moved — Name of the item to be moved (e.g., truck bed, crane, excavator storage container).
Crane Make and Model — If the item being moved is a crane, enter the make and model.
Transport Method — Indicate how the item will be moved: hauled, towed or driven.
Hazardous — Check if the item is hazardous.
Vehicle ID Location — Check if using the license plate or serial number of a truck and trailer combination (trailer) or straight truck (truck).
License Plate Number — Enter the license plate number.
Issuing State — Enter the state from which the license plate is issued.
VIN/Serial Number — Enter the last 5 numbers of the Vehicle Identification Number (VIN) or serial number if the transporter is not licensed.
OVERALL DIMENSIONS/SIDE OVERHANG
Vehicle and Load — Enter the overall height, width and length measurement (feet and inches) of the vehicle and load combination being moved.
Overhang — Side Overhang — Check the appropriate box for overhang distribution. Width Overhang — If you answer no to side overhang, you must
complete the width overhang boxes.
Length Overhang — Enter how much load hangs over the front and rear of the trailer.
Self-propelled Crane — If driving a crane, enter the width from outside of left tire to outside of right tire.
AXLE WEIGHT AND SPACING
Gross Weight — Enter the total weight of the vehicle configuration and load.
Licensed Legal Weight — Enter weight for which the vehicle is legally licensed.
Number of Axles — Enter the total number of axles including the axles on the power unit, trailer and dolly.
If you exceed 9 axles, check the box and complete the additional axle, Virginia Hauling Permit Additional Axle (form HP 403).
Axles — Circle one for each axle.
Weight — Enter the individual weight for each axle circled.
Distance — Enter distance in feet and inches between each pair of axles.
ROUTE
Specific Route — Complete all route boxes.
Starting — Check the appropriate box to indicate the starting point of the trip. Fill in the blank to indicate name of starting point.
Direction — Check which direction you will be heading. Enter route number. If you will be starting within Virginia, enter the distance and direction from the
intersecting route nearest your starting address and starting route number.
Ending — Check the appropriate box as to where you are ending. Fill in the blank to indicate name of ending point.
If you will be ending within Virginia, enter the distance and direction from the intersecting route nearest your ending address and route number.
Route Requested — Enter the desired route you wish to travel.
SIGNATURE
Name — Print the name of the person completing this form.
Signature — Written signature of the person completing this form.
Date — Date this application was signed.
PERMIT SERVICE COMPANY INFORMATION
Prepared by permit service company (PSC) — Check if application was prepared by a permit service company (PSC).
PSC Name — Write the permit service company name here.
PSC (VAHPS or Shipper Federal ID, FEIN, SSN) — Enter the permit service company's VAHPS ID. Otherwise enter the shipper's federal employer
identification number (FEIN) or social security number (SSN).
Telephone Number — Telephone number of person or PSC representative who signed the application.
Fax Number — Fax number of the person or PSC representative who signed the application.
PAYMENT/DELIVERY — Check the requested delivery method. Mail payment with completed application. For credit card payment, fax or mail the
application and the Hauling Permit Office will contact you for payment when the permit is ready to be processed.
INSTRUCTIONS FOR COMPLETING
THE VIRGINIA SUPERLOAD SINGLE TRIP
HAULING PERMIT APPLICATION
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

VIRGINIA SUPERLOAD SINGLE TRIP HAULING PERMIT APPLICATION (Virginia Department of Motor Vehicles)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 2 November 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document