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Hsmv 85900 Form 2011
(OPTIONAL)
TELEPHONE
NUMBER
IF THE ABOVE ADDRESSES OR TELEPHONE NUMBER ARE DIFFERENT FROM
WHAT WAS ON YOUR PREVIOUS APPLICATION PLEASE CHECK THIS BOX:
C – CORRECTION
R – RENEWAL
IRP ACCOUNT NUMBER
TRANSACTION
TYPE
OWNER’S
UNIT
NUMBER
Y
E
A
R
ORIGINAL
RENEWAL
ADD FLEET
ADD STATE
ADD VEHICLE
TRANSFER
INCREASE
WEIGHT
CORRECTION
FLEET TO FLEET
TRANSFER
VEHICLE TYPES
D – DELETE VEHICLE
TT – TRUCK TRACTOR
TR – TRACTOR
VEHICLE
IDENTIFICATION
NUMBER
U.S. DOT
NUMBER
EXEMPT...
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