Hsmv 61518 Form PDF Details

HSMV 61518 Form is a form that you need to fill out in order to get your driver's license. This form can be found on the Florida Department of Highway Safety and Motor Vehicles website. The form requires some basic information, such as your name, date of birth, Social Security number, and so on. Be sure to fill out the form completely and accurately, or you may experience delays in obtaining your driver's license. For more information about HSMV 61518 Form or other driver's license-related matters, please contact the Florida Department of Highway Safety and Motor Vehicles.

Below are some details you might like to examine before working with the hsmv 61518 form.

QuestionAnswer
Form NameHsmv 61518 Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesflorida dot number, CFR, how to apply for dot number in florida, 100-Mile

Form Preview Example

Florida Highway Patrol

Florida DOT Number Application

Mailing Address: Florida Highway Patrol - Commercial Vehicle Enforcement; 2900 Apalachee Parkway MS 41, Tallahassee, FL 32399; or Fax to: (850) 617-5150

UPDATE PURPOSES ONLY

1.

Name of Carrier

 

 

 

 

 

2.

Doing Business As (DBA)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

Physical Street/Address or Route Number

 

4. City

5.

Mailing Address

 

6. City

 

 

 

 

 

 

 

 

 

 

 

 

 

7.

State

 

8. Zip Code + 4

 

 

 

9. Colonia (Mexico Only)

10.

State

11. Zip Code + 4

 

12. Colonia (Mexico Only)

 

 

 

 

 

 

 

 

 

 

 

 

13. Principal Business Phone #

 

 

14.

Principal Contact Cellular #

15.

Principal Business Fax #

 

 

 

(

)

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16.USDOT #

17. MC or MX #

18. Dun & Bradstreet #

19. IRS/Tax ID #

20. Internet Email Address

21.

Company Operations

(Circle all that apply)

 

 

 

 

 

A. Interstate

B. Intrastate Hazmat Carrier

C. Intrastate Non-Hazmat Carrier

D. Interstate Shipper

E. Intrastate Shipper

F. Vehicle Registrant Only

22.

Carrier Mileage (to nearest 10,000 miles for Last Calendar Year)

Year

 

 

 

 

 

 

 

 

23.

Operation Classification:

 

 

 

 

A.

Authorized For-Hire

D. Private Passengers (Business

G.

U.S . Mail

J.

Local Government

B.

Exempt For-Hire

E. Private Passengers (Non-Business)

H.

Federal Government

K.

Indian Tribe

C.

Private (Property)

F. Migrant Workers

I.

State Government

L.

Other (please specify)

______________________

24. Cargo Classification (Please circle all that apply):

 

 

 

 

 

 

A.

General Cargo

G.

Building Materials

M.

Passengers

T.

U.S. Mail

Y.

Paper Products

B.

Household Goods

H.

Mobile Homes

N.

Oil Field Equipment

U.

Chemicals

Z.

Utility

C.

Metal: Sheets, Coils, Rolls

I.

Machinery, Large Objects

O.

Livestock

V.

Commodities Dry Bulk

AA.

Farm Supplies

D.

Motor Vehicles

J.

Fresh Produce

P.

Grain, Feed, Hay

W.

Refrigerated Food

BB.

Construction

E.

Drive Away/Towaway

K.

Liquids/Gases

Q.

Coal/Coke

X.

Beverages

CC.

Water Well

F.

Logs, Poles, Beams, Lumber

L.

Intermodal Container

R.

Meat

 

 

DD.

Other

 

 

 

 

S.

Garbage, Refuse, Trash

 

 

 

 

______________________

25. Hazardous Materials Carried or Shipped (Circle all that apply) C-Carried S-Shipped B(Bulk) – Cargo Tanks NB(Non-Bulk) – In Packages:

C

S

A.

Div 1.1

B

NB

C

S

B.

Div 1.2

B

NB

C

S

C.

Div 1.3

B

NB

C

S

D.

Div 1.4

B

NB

C

S

E.

Div 1.5

B

NB

C

S

F.

Div 1.6

B

NB

C

S

G.

Div 2.1

B

NB

C

S

H.

Div 2.1LPG

B

NB

C

S

I.

Div2.1(Methane)

B

NB

C

S

J.

Div 2.2

B

NB

C

S

K.

Div 2.2A(Ammonia)

B

NB

C

S

L.

Div 2.3A

B

NB

C

S

M.

Div 2.3B

B

NB

C

S

N.

Div 2.3C

B

NB

C

S

O.

Div 2.3D

B

NB

C

S

P.

Class 3

B

NB

C

S

Q.

Class 3A

B

NB

C

S

R.

Class 3B

B

NB

C

S

S.

Comb Liq

B

NB

C

S

T.

Div 4.1

B

NB

C

S

U.

Div 4.2

B

NB

C

S

V.

Div 4.3

B

NB

C

S

W.

Div 5.1

B

NB

C

S

X.

Div 5.2

B

NB

C

S

Y.

Div 6.2

B

NB

C

S

Z.

Div 6.1A

B

NB

C

S

AA.

Div 6.1B

B

NB

C

S

BB.

Div6.1Poison

B

NB

C

S

CC.

Div 6.1Solid

B

NB

C

S

DD.

Class 7

B

NB

C

S

EE.

HRCQ

B

NB

C

S

FF.

Class 8

B

NB

C

S

GG.

Class 8A

B

NB

C

S

HH.

Class 8B

B

NB

C

S

II.

Class 9

B

NB

C

S

JJ.

Elevated Temp Mat

B

NB

C

S

KK.

Infectious Waste

B

NB

C

S

LL.

Marine Pollutants

B

NB

C

S

MM.

Hazardous Sub (rq)

B

NB

C

S

NN.

Hazardous Waste

B

NB

C

S

OO.

ORM

B

NB

 

 

 

 

HazMat

 

 

 

 

 

 

 

PASSENGERS

 

 

 

 

 

 

 

 

Straight

Truck

 

Cargo

HazMat Cargo

 

 

School Bus

 

 

Mini-

 

Van

 

Limousine

 

 

Trailers

Motor

 

 

 

Bus

 

 

 

 

 

 

26. Equipment

Trucks

Tractors

Tank

Tank Trucks

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Trailers

 

Coach

1-8

 

9-15

 

16+

 

16+

1-8

 

9-15

1-8

 

9-15

 

16

 

 

 

 

 

 

 

 

 

 

 

 

+

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Owned

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Term Leased

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Trip Leased

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27. Driver Information

 

Interstate

 

 

Intrastate

 

 

 

 

 

 

 

Total CDL Drivers

 

 

 

 

 

Within 100-Mile Radius

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Beyond 100-Mile Radius

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

28. Is your USDOT Number Registration currently revoked by the Federal Motor Carrier Safety Administration?

Yes

No

29. Please enter name(s) of sole proprietor(s), officers or partners and Titles (e.g., President, Treasurer, General Partner, Limited Partner)

1.

 

 

2.

 

 

(PLEASE PRINT NAME)

 

 

(PLEASE PRINT NAME)

30. Certification Statement (to be completed by an authorized official (i.e., owner, president):

 

 

I, ____________________________,

I certify that I am familiar with the Federal Motor Carrier Safety Regulations and/or the Federal Hazardous Materials Regulations.

 

(Please print name)

Under penalties of perjury, I declare that the information entered on this report is, to the best of my knowledge and belief, true,

 

 

correct and complete.

 

 

Signature:

Date:

 

Title:

HSMV 61518 (08/11)

 

 

 

Florida DOT Number Application Instructions

PLEASE COMPLETE AND RETURN THE ATTACHED APPLICATION TO:

Florida Highway Patrol - Commercial Vehicle Enforcement

2900 Apalachee Parkway, MS 41

Tallahassee, FL 32399

Telephone: (850) 617-2282; Fax: (850) 617-5150

(PLEASE PRINT OR TYPE ALL INFORMATION)

1.Enter the legal name of the business entity (i.e. corporation, partnership, or individual) that owns/controls the motor carrier/shipper operation.

2.If the business entity is operating under a name other than that in Block 1, (i.e., “trade name”) enter that name. Otherwise, leave blank.

3.Enter the street address for the principal place of business where all safety records are kept.

4.Enter the city where the principal place of business is located.

5.Enter mailing address if different from the physical address, otherwise leave blank.

6.Enter the city corresponding with the mailing address.

7.Enter the two-letter postal abbreviation for the State or the name of the Canadian Province/Territory or Mexican State corresponding with the physical address.

8.Enter the zip code + 4 digit number corresponding with the mailing address.

9.Mexico Only.

10.Enter the two-letter postal abbreviation for the State corresponding with the mailing address.

11.Enter the zip code + 4 digit number corresponding with the physical address.

12.Mexico Only.

13.Enter the telephone number, including area code, of the principal place of business.

14.Enter the cellular number of the principal contact.

15.Enter the fax number, including area code, of the principal place of business.

16.Enter the USDOT number assigned to your motor carrier operation by the U.S. Department of Transportation, if previously issued, If this is an UPDATE of your Carrier record the USDOT number must be included.

17.MX or MC number (Not Applicable to Intrastate Operations).

18.Enter the Dun & Bradstreet number.

19.Enter employer identification number (EIN#) assigned to your motor carrier operation by the Internal Revenue Service or your social security number (SS#).

20.Enter your Internet e-mail address, if you have one.

21.Circle the appropriate type of carrier operation.

A.Interstate Carrier: A carrier that transports property, passengers or hazardous materials between or through two or more states or countries.

B.Intrastate Hazmat Carrier: A carrier that transports hazardous materials from one point in a state to another point within the same state, excluding any interstate movement.

C.Intrastate Non-Hazmat Carrier: A carrier that ONLY transports property or passengers from one point in a state to another point within the same state, excluding any interstate movement.

D.Interstate Shipper: A shipper that arranges transportation ACROSS STATE LINES of materials, substances or wastes which may be toxic, harmful or fatal to the environment, humans or animals that are accidentally exposed to them.

E.Intrastate Shipper: A shipper that arranges transportation ONLY WITHIN one state of materials, substances or wastes which may be toxic, harmful or fatal to the environment, humans or animals that are accidentally exposed to them.

F.Registrant: A company that registers commercial motor vehicles with a state office but is not a motor carrier, such as a company that rents or leases vehicles, or a for-hire operator that operates under another company's authority.

"Registrant USDOT Number" does not allow you to operate as a motor carrier and cannot, under any circumstances, be marked on the side of commercial motor vehicles!

22.Enter the carrier’s total mileage to nearest 10,000 miles for the past calendar year, and the year for which the mileage is being reported.

23.Circle appropriate classification. Circle all that apply. If “L. If Other” is circled, enter the type of operation in the space provided.

A.AUTHORIZED FOR HIRE - transportation for compensation as a common or contract carrier of property, owned by others, or passengers under the provisions of the FHWA.

B.EXEMPT FOR HIRE - transportation for compensation of property or passengers exempt from the economic regulation by the FHWA.

C.PRIVATE (PROPERTY) - transportation of property by commercial motor vehicle that is not a for-hire motor carrier.

D.PRIVATE PASSENGERS (BUSINESS) - a private motor carrier engaged in the interstate transportation of passengers which is provided in the furtherance of a commercial enterprise and is not available to the public at large (e.g., bands).

E.PRIVATE PASSENGERS (NON-BUSINESS) - a private motor carrier involved in the interstate transportation of passengers that does not otherwise meet the definition of a private motor carrier of passengers (business) (e.g., church buses).

F.MIGRANT - interstate transportation, including a contract carrier, but not a common carrier of 3 or more migrant workers to or from their employment by any motor vehicle other than a passenger automobile or station wagon.

G.U.S. MAIL - transportation of U.S. Mail under contract with the U.S. Postal Service.

H.FEDERAL GOVERNMENT - transportation of property or passengers by a U.S. Federal Government agency.

I.STATE GOVERNMENT - transportation of property or passengers by a U.S. State Government agency.

J.LOCAL GOVERNMENT - transportation of property or passengers by a local municipality.

K.INDIAN TRIBE - transportation of property or passengers by an Indian tribal government.

L.OTHER - transportation of property or passengers by an operation classification not described above.

24.Circle all the letters of the types of cargo you usually transport. If “Other” is circled, enter the name of the commodity in the space provided.

25.Circle all types of hazardous materials (HM) you transport/ship. In the columns before HM types, circle “C” for a carrier of HM and “S” for a shipper of HM. In the columns following the HM types, circle “B” if the HM is transported in bulk (over 119 gallons) and “NB” if the HM is transported in non-bulk (119 gallons or less). The HM types correspond to the classes and divisions listed in 49 CFR 173.2. Below are clarifications of some of the lettered codes:

H. Div 2.1LPG - Liquefied Petroleum Gas

I.

Div 2.1(Methane)-Methane Gas

K. Div 2.2A-Anhydrous Ammonia

L. Div 2.3A-Poison Gas which is Poison Inhalation Hazard (PIH) Zone

M. Div 2.3B-Poison Gas which is PIH Zone B

N. Div 2.3C-Poison Gas which is PIH Zone C

O. Div 2.3D-Poison Gas which is PIH Zone D

Q. Class 3A-Flammable Liquid which is PIH Zone A

R. Class 3B-Flammable Liquid which is PIH Zone B

S.

Combustible Liquid

Z. Div 6.1A-Poison Liquid which is PIH Zone A

AA. Div 6.1B-Poison Liquid which is PIH Zone B

BB. Div 6.1 Poison-Poison Liquid with no inhalation

CC. Div 6.1 Solid-Poison Solids

hazard

GG. Class 8A-Corrosive Liquid which is PIH Zone A

EE. HRCQ-Highway Route Controlled Quantity

HH. Class 8B-Corrosive Liquid which is PIH Zone B

of Radioactive Material

 

 

NOTE: Information on Poison Inhalation Hazards is found in column (7) of the hazardous materials table (49 CFR 172.101)

26.Enter the total number of vehicles owned, term leased and trip leased, that are, or can be, operational the day this form is completed.

Passenger vehicles are defined as:

MOTOR COACH - a vehicle designed for long distance transportation of passengers, usually equipped with storage racks above the seats and a baggage hold beneath the passenger compartment.

SCHOOL BUS - a vehicle designed and/or equipped mainly to carry primary and secondary students to and from school, usually built on a medium or large truck chassis.

MINI-BUS/VAN - a multi-purpose passenger vehicle with a capacity of 10-24 people, typically built on a small truck chassis. LIMOUSINE - a passenger vehicle usually built on a lengthened automobile chassis.

27.Enter the number of interstate/intrastate drivers used on an average workday. Part-time, casual, term leased, trip leased and company drivers are to be included. Also, enter the total number of drivers and the total number of drivers who have a Commercial Drivers License (CDL).

INTERSTATE - driver transports people or property across State lines, including international boundaries, or wholly within one State as part of a through movement that originates or terminates in another State or country.

FLORIDA (INTRASTATE) - driver transports people or property wholly within Florida.

100-MILE RADIUS DRIVER - driver operates only with a 100 air-mile radius of the normal work reporting location.

28.Is your USDOT Number Registration currently revoked by the Federal Motor Carrier Safety Administration?

29.Print or type name in the space provided, of the individual authorized to sign documents on behalf of the entity listed in Block 1, sole proprietor, officer or partners and titles (e.g., President, Treasurer, General Partner, Limited Partner, Owner). That individual must sign, date, and show his or her title in the spaces provided (Certification Statement, see 49 CFR 390.19).

30.Certification Statement to be signed by authorized official (i.e., Owner or President).

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