IFTA Registration Online Form – IFTA – International Fuel Tax Agreement

Carrier Info Confirm Your Official Representative
Vehicle Details Add Vehicles
Questionnaire Additional Info
Payment Info Pay and Complete Registration

Carrier Information

Step 1 - 3

Who is Filing the Form*

Email Address*

Business Phone*

Mobile* Same as Business Ph

Application Type*

Base State *

License Year*

IFTA Account Number*

Additional Carrier Info Required for the state of

Secretary of State Entity Number*

NCDOR ID/State Number*

County Number*

Secretary of State Business ID*

KYTC Number*

Date of Incorporation *

State of Commercial Domicile*

Bank Name*

Bank Account Number*

Bank Phone*

Bank Address*

Business Type*

USDOT*

Individual Carrier Opertaion Details

Individual Owner name *

Owner SSN*

Date Of birth*

Start Date In Current Position*

USDOT of Carrier You Operate Under*

Owner Residential Address*

Name (First & Last)*

Title*

SSN*

Date Of Birth*

Start Date In Current Position*

Owner's Name (First & Last)*

Position*

SSN EIN

Date Of birth*

Start Date In Current Position*

Physical Address

Mailing Address Same as Physical Address

Required Documents

Owner Driver's Licence

Articles of Organization

Note: if you don't have these documents prepared, you can skip this step for now. We'll send you an email with a list of any documents that we still need from you before we can process your order.

Vehicle Details

Step 2 - 3

VIN*

Type of fuel used*

Additional Decal Set (1 Set = 2 Decals) *

License Plate Number*

Vehicle Registration Number*

Base State*

Vehicle Status*

No.	VIN	Fuel Type	Action
ADD A VEHICLE
Total Cost: $

Questionnaire

Step 3 - 4

Have you ever been issued an IFTA from any Jurisdiction?

Yes

Have you had an IFTA license revoked or canceled by another Jurisdiction?

Yes

Do you lease vehicles?

Yes

Additional Details Required for the state of

Will you be operating vehicles in Connecticut that are required to pay the Highway Use Fee??

Yes

Is your business incorporated in Indiana?

Yes

Was your license cancelled in good standing?

Yes

Have you ever had a KY Intra For-Hire Certificate issued to you in another name?

Yes

Was the certificate cancelled?

Yes

Are your vehicles involved in a lease agreement?

Yes

Are your vehicles involved in a lease agreement?

Yes

When did your/will your Rhode Island IFTA registration become active?

Do you have bulk storage?

Yes

List one jurisdiction besides Washington State that you will be operating in.

Are you registered for the New York Highway Use Tax?

Yes

When did your/will your Rhode Island IFTA registration become active?

Do you currently operate dual-fuel qualified vehicles?

Yes

Do you currently operate dual-fuel qualified vehicles?

Yes

Do you currently operate dual-fuel qualified vehicles?

Yes

Do you currently operate dual-fuel qualified vehicles?

Yes

Do you have a currently active or previously active CCD Acc. number?

Yes

Do you have a currently active or previously active IRP Acc. number?

Yes

Do you have a currently active or previously active IFTA Acc. number?

Yes

Do you currently operate dual-fuel qualified vehicles?

Yes

When did your/will your Rhode Island IFTA registration become active?

Have you previously held an IFTA license in Washington State?

Yes

List one jurisdiction besides Washington State that you will be operating in.

Have you ever been issued an IFTA license by another IFTA jurisdiction?

Yes

Were you ever affiliated with a company whose license has been revoked?

Yes

In which jurisdiction are your vehicles currently plated?

Yes

Describe the nature of the business requiring the use of a motor vehicle and list the commodities you transport.

Payment Information

Step 4 - 4

Order Details

Vehicle Total	:
Total Cost	:	$

Billing Address

New Billing Address

Billing Address Same as Physical Address

Billing Address Same as Mailing Address

Address*

City*

State*

Zip Code*

I certify that I am the authorized holder and signer of the credit card referenced above. I certify that all the information above is complete and accurate.

I hereby authorize the collection of payment for all charges as indicated above. Charges may not exceed the amount listed above in the “TOTAL COST” field. I understand this is only for up to this amount on the date listed below in the "DATE SIGNED" field. If additional charges are going to be authorized, a new form will have to be completed.

The “TOTAL COST” includes all federal, state and local government fees.

I hereby acknowledge and agree that after the charges are authorized, a DOT Operating Authority agent is assigned in 15 minutes to run the order. Once the agent is assigned, the charges become non-refundable.

I agree with the Terms and Conditions

Name of Person Signing

Title

Official Representative

Date signed

03/25/2023

Signature

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IFTA Registration Form