Get MCSA-5889 2021-2023
FORM MCSA-5889 OMB No. 2126-0060 Revised 08/13/2015 Expiration 7/31/2018 A federal agency may not conduct or sponsor and a person is not required to respond to nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2126-0060. Public reporting for this collection of information is estimated to be approximately 15 minutes per response including the time for reviewing instructions gathering the data needed and completing and reviewing the of this collection of information including suggestions for reducing this burden to Information Collection Clearance Officer Federal Motor Carrier Safety Administration MC-RRA 1200 New Jersey Avenue SE Washington D*C* 20590. United States Department of Transportation Federal Motor Carrier Safety Administration FMCSA Office of Registration Safety Information 6th Floor 1200 New Jersey Ave. SE Washington DC Fax 202 366-3477 Licensing 202 385-2422 Insurance Customer Service 800 832-5660 Motor Carrier Records Change Form Name and address changes and reinstatements of operating authority can be requested on our web site at https //li-public*fmcsa*dot. gov/LIVIEW/PKG REGISTRATION*prcoption supporting documents must be submitted separately. You may submit this form to the above address via our web form at https //ask. fmcsa*dot. gov/app/ask or fax it to 202-366-3477. There is no fee for an address change but name changes cost 14 and reinstatements 80. For more assistance with these transactions and other Registration Licensing and Insurance functions including transfers of operating authority see the FAQs at https //ask. fmcsa*dot. gov* Please submit all the requested data in Section A as represented in your current DOT records. Changes can be indicated in Section B for address changes Section C for name changes and Section D for Reinstatements. Credit card information can be submitted in Section E* Any partially-submitted data will be kept for 30 days. If the rest of the information is not submitted within that time the submitted data will be discarded* FMCSA cannot make any changes until all required data is supplied* Section A ALL MUST COMPLETE TODAY S DATE REQUESTOR S FAX NUMBER include area code REQUESTOR S E-MAIL ADDRESS if any MOTOR CARRIER IDENTIFICATION INFORMATION CURRENT LEGAL NAME personal partnership or corporation DOCKET/MC NUMBER CURRENT DOING BUSINESS AS NAME if different from legal name MX NUMBER MX only DOT NUMBER FF NUMBER freight forwarders only ADDRESSES as currently listed in FMCSA systems STREET ADDRESS PHONE NUMBERS CURRENT BUSINESS NUMBER include area code YT WY WV WI WA VT VI VA UT TX TN SK SD SC RI QC PW PR PE PA OR ON OK OH NY NV NU NT NS NM NL NJ NH NE ND NC NB MT MS MP MO MN MI MH ME MD MB MA LA KY KS IN IL ID IA HI GU GA FM FL DE DC CT CO CA BC AZ AS AR AL AK AB STATE/PROV.
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