Get ME UCR-2 2017-2024

UNIFIED CARRIER REGISTRATION FORM UCR-2 VEHICLES OWNED AND OPERATED FOR THE 12 MONTH PERIOD ENDING June 30 2016 UCR REGISTRATION YEAR 2017 Note This form is provided to assist you in maintaining required information. Carriers may also submit the requested data in electronic format or in printout attached to this form. Contact your state agency for acceptable data formats. SECTION 1. GENERAL INFORMATION USDOT Number MC or MX Number FF Number Telephone Number Legal Name E-Mail Address Doing Business Under The Following Name DBA Principal Place Of Business Street Address See Instructions Principal Business City Zip Code Mailing State Mailing Zip Code Mailing Street Address Mailing City SECTION 2. CLASSIFICATION Check All That Apply Motor Carrier Motor Private Carrier SECTION 3. VEHICLE LIST The above described carrier hereby declares that the following vehicles are the total number owned and operated for the 12 month period ending June 30 2016 MAKE MODEL/GVWR/ LICENSE PLATE VIN NUMBER Number of Passengers NUMBER/STATE A STRAIGHT TRUCKS AND TRACTORS B. MOTOR COACHES SCHOOL BUSES MINIBUSES VANS AND LIMOUSINES Use reverse side if needed* SECTION 4. CERTIFICATION I the undersigned under penalty for false statement certify that the above information is true and correct and that I am authorized to execute and file this document on behalf of the applicant. Penalty provisions subject to the laws of the registration state. Name Of Owner Or Authorized Representative Printed Signature Date Title VEHICLE LIST CONTINUED Carrier Name Make additional copies of this sheet if needed Page of. SECTION 1. GENERAL INFORMATION USDOT Number MC or MX Number FF Number Telephone Number Legal Name E-Mail Address Doing Business Under The Following Name DBA Principal Place Of Business Street Address See Instructions Principal Business City Zip Code Mailing State Mailing Zip Code Mailing Street Address Mailing City SECTION 2. CLASSIFICATION Check All That Apply Motor Carrier Motor Private Carrier SECTION 3. VEHICLE LIST The above described carrier hereby declares that the following vehicles are the total number owned and operated for the 12 month period ending June 30 2016 MAKE MODEL/GVWR/ LICENSE PLATE VIN NUMBER Number of Passengers NUMBER/STATE A STRAIGHT TRUCKS AND TRACTORS B. CLASSIFICATION Check All That Apply Motor Carrier Motor Private Carrier SECTION 3. VEHICLE LIST The above described carrier hereby declares that the following vehicles are the total number owned and operated for the 12 month period ending June 30 2016 MAKE MODEL/GVWR/ LICENSE PLATE VIN NUMBER Number of Passengers NUMBER/STATE A STRAIGHT TRUCKS AND TRACTORS B. MOTOR COACHES SCHOOL BUSES MINIBUSES VANS AND LIMOUSINES Use reverse side if needed* SECTION 4. CERTIFICATION I the undersigned under penalty for false statement certify that the above information is true and correct and that I am authorized to execute and file this document on behalf of the applicant. MOTOR COACHES SCHOOL BUSES MINIBUSES VANS AND LIMOUSINES Use reverse side if needed* SECTION 4. CERTIFICATION I the undersigned under penalty for false statement certify that the above information is true and correct and that I am authorized to execute and file this document on behalf of the applicant. Penalty provisions subject to the laws of the registration state. Name Of Owner Or Authorized Representative Printed Signature Date Title VEHICLE LIST CONTINUED Carrier Name Make additional copies of this sheet if needed Page of. .