Dmv Form Oa 144M PDF Details

The DMV (Department of Motor Vehicles) form Oa 144M is a document that can be used to prove your residency in California. This form is used to establish residency for the purpose of obtaining a driver license or identification card. In order to complete the form, you will need to provide certain information about yourself and your residence. The form must be signed and dated by the applicant. NOTE: depending on your specific situation, you may also be required to provide additional documentation. For more information, please consult the DMV website or contact your local DMV office. Thank you for choosing DMV Form Oa 144M!

QuestionAnswer
Form NameDmv Form Oa 144M
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesva operating authority, operating authority license, virginia dmv certificate, va hire license

Form Preview Example

FOR-HIRE INTRASTATE OPERATING AUTHORITY

CERTIFICATE, LICENSE, OR PERMIT

RENEWAL APPLICATION

OA 144M (01/01/2018)

PURPOSE: Motor carriers use this form to renew their Intrastate Operating Authority Certificate, License and/or Permit(s) and provide business operations information.

INSTRUCTIONS: Complete all sections. Unsigned applications cannot be processed. For-hire certificates/licenses can be denied, revoked or suspended due to certain circumstances. Refer to www.dmvNow.com for specific denial/revocation/suspension reasons.

SECTION 1 — AUTHORITY INFORMATION

Check all that apply:

 

Broker of Passenger

 

Contract Passenger

 

Sightseeing

 

Employee Hauler

 

Taxicab

 

Nonprofit / Tax Exempt Passenger Carrier

 

 

 

 

Common Carrier-Irregular Route

 

Household Goods

 

Non-Emergency Medical Transportation Carrier

 

 

 

 

Common Carrier-Regular Route

 

Property Carrier

 

 

 

 

 

 

Write the number of each certificate, license, and permit you are applying to renew. Attach a separate page if needed.

SECTION 2 — BUSINESS INFORMATION

BUSINESS NAME (For individual applicants, give your full legal name)

 

FEDERAL TAX IDENTIFICATION NUMBER/SSN

 

 

 

 

 

TRADE NAME OR DOING BUSINESS AS (if different from Business Name)

 

 

 

 

 

 

 

 

BUSINESS STREET ADDRESS (do not give P.O. Box)

CITY

STATE

ZIP CODE

 

 

 

 

BUSINESS MAILING ADDRESS (if different from above)

CITY

STATE

ZIP CODE

 

 

 

 

 

PRIMARY CONTACT PERSON NAME

 

TELEPHONE NUMBER

FAX NUMBER

 

 

 

 

 

PRIMARY CONTACT PERSON TITLE

PRIMARY CONTACT PERSON EMAIL ADDRESS

 

 

 

 

 

 

 

SECTION 3 — OTHER CARRIER INFORMATION

IRP ACCOUNT NUMBER (if applicable)

BASE STATE

IFTA LICENSE NUMBER (if applicable)

BASE STATE

 

 

 

 

FMCSA MC NUMBER (Federal Motor Carrier) (if applicable)

 

DOT NUMBER (if applicable)

 

 

 

 

 

SECTION 4 — BUSINESS ENTITY INFORMATION

4A. BUSINESS ENTITY TYPE (check one)

 

CORPORATION

 

PARTNERSHIP (Complete Section 4B below)

 

INDIVIDUAL

 

OTHER

4B. PARTNERSHIP INFORMATION (enter the following information for all partners)

FULL LEGAL NAME

SOCIAL SECURITY NUMBER

 

 

 

 

 

 

 

 

 

 

SECTION 5 — CERTIFICATION

I affirm that all taxes, fees, penalties, interest, and judgements due the Commonwealth of Virginia have been paid or satisfied and that I am in compliance with the Worker's Compensation Act of Title 65.2 and with the Business, Professional, and Occupational License Tax requirements. 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. I understand that any Virginia Operating Authority certificate, license or permit issued to me can be suspended and revoked if any of the information in the application is found to be untrue or inaccurate.

APPLICANT OR AUTHORIZED REPRESENTATIVE NAME

APPLICANT OR AUTHORIZED REPRESENTATIVE TITLE

 

 

 

APPLICANT OR AUTHORIZED REPRESENTATIVE SIGNATURE

DATE (mm/dd/yyyy)

 

 

 

 

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Filling out segment 1 in virginia dmv certificate

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virginia dmv certificate writing process described (part 2)

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