Follow the steps to complete the FMCSA ELD Malfunction Extension Request Information Sheet

1. Press the ‘Get Form’ button to access the form and open it in the online editor.
2. In the first field, provide the motor carrier name. Ensure that this is the official name registered with the Department of Transportation (DOT).
3. Enter the U.S. DOT number in the designated field. This number is unique to your motor carrier and can typically be found in your registration documents.
4. Fill in the name of the person making the request in the appropriate section. This should be a representative of the motor carrier.
5. Input the address of the person making the request, ensuring it is complete with street address, city, state, and ZIP code.
6. Provide the telephone number of the person making the request, including the area code.
7. List the ELD manufacturer or provider for each device in your fleet.
8. Specify the name of the ELD device you are using.
9. Document the model of the malfunctioning ELD. This information can usually be found on the device itself.
10. Enter the serial number(s) for each ELD in use, which is crucial for identification and tracking of the devices.
11. Indicate the software version being utilized. This information is vital for understanding compatibility and troubleshooting.
12. Record the date of installation for each ELD. Accurate records help in assessing the lifespan and reliability of the devices.
13. Provide the date and location of each ELD malfunction. This will assist in tracking patterns of failure.
14. Estimate a completion date for the repairs or solution for the malfunctioning ELD.
15. State the anticipated outcome whether it involves repair, replacement, or servicing of the ELD.
16. If a replacement is necessary, specify the new vendor or product associated with the new ELD.
17. Include a list of vehicles (power unit numbers or vehicle identification numbers) and drivers who will be using this extension.
18. Describe the actions taken by the motor carrier to repair, replace, or service the ELDs, including a justification for the need for additional time beyond the eight days allowed as per §395.34.
19. Affix the signature of the motor carrier official to validate the request.
20. Lastly, enter the date the document is signed to complete your submission.
21. Once all information is entered, review for accuracy, and then save the changes, download, print, or share the form as needed.

Complete your FMCSA ELD Malfunction Extension Request Information Sheet online for submission today.