Get FMCSA OCE-46 2020-2024

London KY 40741 The original form must be submitted. Faxed E-mailed or photocopied forms will not be accepted. The attached Form OCE-46 the carrier and authorized signature and notarized in order that FMCSA may process your request. City/County Subscribed and sworn to before me this Affix Notary Seal 31st 30th 29th 28th 27th 26th 25th 24th 23rd 22nd 21st 20th 19th 18th 17th 16th 15th 14th 13th 12th 11th 10th day of 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 December November October September August July June May April March February January Notary Signature My commission expires on / 2028 Name/Title of witnessing FMCSA staff member please type or print Witnessed on FMCSA staff member signature FORM OCE-46 Page 1 of 2 Please return Form OCE-46 Request for Revocation of Authority Granted to 460 Industrial Blvd. FORM OCE-46 OMB No. 2126-0018 Revised 09/27/2017 Expiration 09/30/2020 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 2126-0018. 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 collection of information* All responses to this collection of information are mandatory. Send comments regarding this burden estimate or any other aspect of this collection of information including suggestions for reducing this burden to Information Collection Clearance Officer Federal Motor Carrier Safety Administration MC-RRA Washington D*C* 20590. United States Department of Transportation Federal Motor Carrier Safety Administration Office of Registration and Safety Information Request for Revocation of Authority Granted Docket Number Name of carrier freight forwarder or broker making request Address of requesting carrier Street City State/Province Postal Code American Alberta Alaska Alabama British Arkansas Arizona District Delaware Connecticut Colorado California Marshall Manitoba Maine Louisiana Kentucky Kansas Iowa Indiana Illinois Idaho Hawaii Guam Georgia Florida Nevada Nebraska Montana Missouri Mississippi Minnesota Micronesia Michigan Massachusetts Maryland New Newfoundland North Northern Northwest Nova Prince Pennsylvania Palau Oregon Ontario Oklahoma Ohio Nunavut Puerto Rhode Quebec Saskatchewan South Virgin Vermont Utah Texas Tennessee West Washington Yukon Wyoming Wisconsin Brunswick Hampshire Jersey Mexico York Scotia Carolina Dakota Edward Island Columbia Rico ofIslands Marianas Samoa Territories and Labrador For the reasons stated below this carrier freight forwarder or broker which is the holder of the above-identified permit s certificate s or license s hereby requests revocation of such registration to the extent specified in accordance with the provisions of 49 U*S*C.