Tdf 19 Form PDF Details

Navigating the maze of regulatory requirements can be a daunting task for motor carriers. Enter the TDF 19 form, a vital document for those in the transport sector operating within Oklahoma. This Motor Carrier Identification Report, crucial for obtaining a USDOT Number, serves as an application that every motor carrier must familiarize themselves with. Administered by the Oklahoma Corporation Commission's Transportation Division, the form covers a wide array of essential information. It distinguishes between new applications, biennial updates or changes, reapplication, and notices of going out of business. The comprehensive details it solicits range from basic identification information, such as the carrier's name and address, to more complex data like cargo classifications and hazardous materials carried. Furthermore, it requires details on the carrier operation types, whether intrastate or interstate, and the specific cargo types transported. This form doesn't just stop at cargo; it extends to vehicle and driver information, indicating the breadth of data needed for compliance. The certification statement at the form's conclusion underscores the seriousness of the information provided, requiring an authorized official's signature to attest to the accuracy and completeness under penalty of perjury. Whether you are stepping into the transport industry or are looking to update your current status, understanding the TDF 19 form is a step towards ensuring regulatory compliance in Oklahoma's vibrant transportation sector.

QuestionAnswer
Form NameTdf 19 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namestdf19, form tdf 19, tdf oklahoma, ok tdf 19

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TDF 19

MOTOR CARRIER IDENTIFICATION REPORT

(Application for USDOT Number)

OKLAHOMA CORPORATION COMMISSION, TRANSPORTATION DIVISION

P.O. BOX 52000, OKLAHOMA CITY, OK 73152-2000

Fax (405) 521-2916

 

REASON FOR FILING (Mark only one) G New Application

G Biennial Update or Changes

G Out of Business

G Reapplication

 

1.

Name of Carrier/PIN

 

 

9.

Doing Business as (DBA) Name

 

 

 

 

 

 

 

 

 

 

 

2.

Physical Street Address/Route Number

 

10.

Mailing Address/P.O. Box

 

 

 

 

 

 

 

 

 

 

 

 

3.

City

4. State

 

11.

City

 

12.

State

 

 

 

 

 

 

 

 

 

 

 

5.

Zip

6. Phone Number

 

13.

Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

7. Cell Phone Number

8. USDOT No.

14. FEIN

(Corp. or Partnerships)

15.SSN (Individuals)

16. Carrier Mileage (to nearest 10,000 miles for last calendar year)

 

 

 

 

 

Year

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17. Carrier Operation (Circle One) A. Interstate B. Intrastate Only (Hazardous Materials) C. Intrastate Only (Non-Hazardous Materials)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18. Operation Classification (Circle one) A. Authorized For-Hire

B. Private (Property)

19. e-mail address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20. Cargo Classifications (Circle All That Apply)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A

General Freight

G

Building Materials

 

 

L

 

Intermodal Cont.

 

 

R

Meat

 

 

 

 

X

Beverages

 

 

B

Household Goods

H

Mobile Homes

 

 

M

 

Passengers

 

 

S

Garbage,Refuse,Trash

Y

Paper Products

 

C

Metal: Sheets, Coils,

I

Machinery, large

 

 

N

 

Oilfield Equipment

 

 

T

U.S. Mail

 

 

 

Z

Utility

 

 

 

 

Rolls

 

 

 

objects

 

 

O

 

Livestock

 

 

U

Chemicals

 

 

 

AA

Farm Supplies

 

D

Motor Vehicles

J

Fresh Produce

 

 

P

 

Grain, Feed, Hay

 

 

V

Commodities Dry Bulk

BB

Construction

 

E

Drive away /Towaway

K

Liquids/Gases

 

 

Q

 

Coal/Coke

 

 

W

Refrigerated Food

 

 

CC

Water Well

 

 

F

Logs,Poles,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DD

Other __________

 

Beams,Lumber

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21.

Hazardous Materials Carried/Shipped (Circle All that Apply)

C=Carried

 

S=Shipped

B=In Bulk N=In Non Bulk

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

S

A. DIV 1.1

 

 

B

N

C

S

O. DIV 2.3D

 

B

 

N

 

C

S CC. DIV 6.1 SOLID

 

B

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

S

B. DIV 1.2

 

 

B

N

C

S

P. CLASS 3

 

B

 

N

 

C

S DD. CLASS 7

 

 

 

B

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

S

C. DIV 1.3

 

 

B

N

C

S

Q. CLASS 3A

 

B

 

N

 

C

S EE. HRCQ

 

 

 

 

B

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

S

D. DIV 1.4

 

 

B

N

C

S

R. CLASS 3B

 

B

 

N

 

C

S FF.

CLASS 8

 

 

 

B

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

S

E. DIV 1.5

 

 

B

N

C

S

S. COMB LIQUID

 

B

 

N

 

C

S GG. CLASS 8A

 

 

 

B

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

S

F. DIV 1.6

 

 

B

N

C

S

T.

DIV 4.1

 

B

 

N

 

C

S HH. CLASS 8B

 

 

 

B

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

S

G. DIV 2.1

 

 

B

N

C

S

U.

DIV 4.2

 

B

 

N

 

C

S II.

CLASS

9

 

 

 

B

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

S

H. DIV 2.1LPG

 

 

B

N

C

S

V. DIV 4.3

 

B

 

N

 

C

S JJ.

ELEVATED TEMP MAT

B

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

S

I.

DIV 2.1(METHANE)

 

B

N

C

S

W. DIV 5.1

 

B

 

N

 

C

S KK.

INFECTIOUS WASTE

 

B

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

S

J

DIV 2.2

 

 

B

N

C

S

X.

DIV 5.2

 

B

 

N

 

C

S LL.

MARINE POLLUTANTS

B

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

S

K. DIV2.2A(AMMONIA)

 

B

N

C

S

Y.

DIV 6.2

 

B

 

N

 

C

S MM. HAZARDOUS SUB(RQ)

B

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

S

L. DIV 2.3A

 

 

B

N

C

S

Z. DIV 6.1A

 

B

 

N

 

C

S NN.

HAZARDOUS WASTE

B

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

S

M. DIV 2.3B

 

 

B

N

C

S

AA. DIV 6.1B

 

B

 

N

 

C

S OO. ORM

 

 

 

 

B

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

S

N. DIV 2.3C

 

 

B

N

C

S

BB. DIV 6.1 POISON

 

B

 

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

22.

 

 

 

Straight

 

Truck

 

Trailers

 

 

HazMat

HazMat

 

 

 

Cars

 

 

 

PASSENGERS

 

 

 

Number of

 

Trucks

Tractors

 

 

 

 

Cargo Tank

Cargo Tank

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Taxicab

 

Mini-bus/Van

Limousine

Equipment

 

 

 

 

 

 

 

 

 

Trailers

Trucks

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Owned

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Term Leased

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

23. Number of Drivers Subject to Motor Carrier Safety Regulations:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INTERSTATE

 

 

 

 

 

INTRASTATE

 

 

 

Total Drivers ________

 

 

 

 

 

 

100-Mile Radius

________

 

 

 

 

100 Mile-Radius

_________

 

 

 

 

 

 

 

 

 

 

 

 

Beyond 100-Mile Radius

________

 

 

 

 

 

 

 

 

 

 

 

 

Total CDL Drivers ________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Beyond 100-Mile Radius

__________

 

 

 

 

 

 

 

 

 

 

24. Certification Statement (To be completed by an authorized official)

I,

,

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

 

(Please print name)

 

 

Hazardous Materials Regulations.

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 _____________________________

 

 

 

 

 

F:\User_Tr\Data\Safety\USDOTMCMIS\TDF19 2-14

INSTRUCTIONS FOR COMPLETING THE MOTOR CARRIER IDENTIFICATION REPORT (TDF 19)

(Print or Type All Information)

1.Enter the legal name of the business entity (i.e., corporation, partnership, or individual) that owns/controls the carrier operation. Show the PIN issued to the carrier by the OCC.

2.Enter the principal place of business street address (where all safety records are maintained).

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

4.Enter the two-letter postal abbreviation for the state in which the principal place of business is located.

5.Enter the zip code number corresponding to the street address.

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

7.Enter the cell telephone number for the business.

8.Enter the identification number assigned to your motor carrier operation by the U.S. D.O.T., if known.

9.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.

10.Enter the mailing address if different from the physical address, otherwise leave blank. This instruction also applies to #11, #12, and #13.

11.Enter the city corresponding to the mailing address.

12.Enter the two-letter postal abbreviation for the state corresponding to the mailing address.

13.Enter the zip code number corresponding to the mailing address.

14.Enter the federal employer identification number (FEIN) for corporations or partnerships assigned to your carrier operation. To apply for a FEIN, contact the IRS at 1-800-829-4933 or on line at www.irs.gov.

15.Enter the social security number (SSN) for sole proprietors.

16.Carrier Mileage — Enter the total mileage of all Commercial Motor Vehicles (CMV) in the company’s operation to the nearest 10,000 miles for the last calendar year (e.g., 2013).

17.Circle the appropriate type of carrier operation.

INTERSTATE - transportation of persons or property across state lines or wholly within one state as part of a through movement that originates or terminates in another state or country.

INTRASTATE - transportation of persons or property wholly within one state.

18.Circle appropriate classification. Circle all that apply.

AUTHORIZED FOR HIRE - transportation for compensation as a licensed motor carrier of property owned by others, or passengers or a certificate holder for household goods.

PRIVATE (Property) - a person who provides transportation of property by commercial motor vehicle and is not a for-hire motor carrier.

19.Enter the e-mail address for the official point of contact, if you have one.

20.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.

21.Circle all the letters of the types of hazardous materials (HM) you transport/ship. In the columns before the HM types, circle either C for

 

carrier of HM or S for shipper of HM. In the columns following the HM types, circle either B if the HM is transported in Bulk (over 119

 

gallons) or N if the HM is transported in Non-bulk (119 gallons or less). (49 CFR 173.2) Below are clarifications of the lettered codes:

A. Div 1.1 Explosives (with mass explosion hazard)

Y.

Div 6.2 Infectious substance (Etiologic agent)

B.

Div 1.2 Explosives (with projection hazard)

Z.

Div 6.1 A (Poison Liquid which is a PIH Zone A)

C.

Div 1.3 Explosives (with predominantly fire hazard)

AA.

Div 6.1 B (Poison Liquid which is a PIH Zone B)

D.

Div 1.4 Explosives (with no significant blast hazard)

BB.

Div 6.1 Poison (Poisonous liquid with no inhalation hazard)

E.

Div 1.5 Very insensitive explosives; blasting agents

CC.

Div 6.1 Solid (meets the definition of a poisonous solid)

F.

Div 1.6 Extremely insensitive detonating substances

DD.

Class 7 Radioactive material

G.

Div 2.1 Flammable gas

EE.

HRCQ (Highway Route Controlled Quantity of Radioactive

H.

Div 2.1 LPG (Liquefied Petroleum Gas)

 

material)

I.

Div 2.1 Methane Gas

FF.

Class 8 Corrosive material

J.

Div 2.2 Non-flammable compressed gas

GG.

Class 8 A (Corrosive liquid which is a PIH Zone A)

K.

Div 2.2 A (Anhydrous Ammonia)

HH. Class 8 B (Corrosive liquid which is a PIH Zone B)

L. Div 2.3 A (Poison Gas which is Poison inhalation Hazard

II.

Class 9 Miscellaneous hazardous material

 

(PIH) Zone A)

JJ.

Elevated Temperature Material (Meets definition in 49 CFR

M. Div 2.3 B (Poison Gas which is PIH Zone B)

 

171.8 for an elevated temperature material)

N.

Div 2.3 C (Poison Gas which is PIH Zone C)

KK. Infectious Waste (Meets definition in 49 CFR 171.8 for an

O.

Div 2.3 D (Poison Gas which is PIH Zone D)

 

infectious waste)

P.

Class 3 Flammable and combustible liquid

LL.

Marine Pollutants (Meets definition in 49 CFR 171.8 for a

Q.

Class 3 A (Flammable liquid which is a PIH Zone A)

 

marine pollutant)

R.

Class 3 B (Flammable liquid which is a PIH Zone B)

MM. Hazardous Sub (RQ) (Meets definition in 49 CFR 171.8 of a

S.

Combustible Liquid (Refer to 49 CFR 173.120(b)

 

reportable quantity of a hazardous substance)

T.

Div 4.1 Flammable solid

NN.

Hazardous Waste (Meets definition in 49 CFR 171.8 of a

U.

Div 4.2 Spontaneously combustible material

 

hazardous waste)

V.

Div 4.3 Dangerous when wet material

OO.

ORM (Meets definition in 49 CFR 171.8 of Other Regulated

W.

Div 5.1 Oxidizer

 

material)

X.

Div 5.2 Organic peroxide

 

 

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

22.Enter the total number of vehicles owned, term leased and trip leased, that are, or can be, operational the day this form is completed. TAXICAB - a service utilizing vehicles having a seating capacity of less than 7 passengers not operated on a regular route or between specified points.

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.

23.Enter the number of interstate/intrastate drivers used on an average work day. 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/INTRASTATE - see definitions in #17.

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

24.Print or type the name, in the space provided, of the individual authorized to sign documents on behalf of the entity listed in Block 1. That individual must sign, date, and show his or her title in the spaces provided.

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