Bell and Associates : Licensing & Permitting : New Customers

Bell & Associates : Licensing & Permitting : New Customer Questionnaire

Bell & Associates is a nationwide trucking consulting firm for the transportation industry specializing in licensing, permitting and fuel taxes. We offer “personalized service” for base state registrations, federal highway use tax, fuel tax accounting, process agents, IFTA applications, IRP licensing, T.K. Refunds, Title Applications and much more. Please fill out the following New Customer Questionnaire to help us assist you.
Company Name:
Address:
Phone:
Contact Name:
Email:
IRP Account #:
State:
County:
Federal ID#:
US DOT#:
Number of Tractors and Weights:

Number of Straight Trucks and Weights:

Number of Trailers:
List Corporate Officers, Title and Social Security Number:

State and Date of Incorporation:

Current License Plates (Name and Account Number)

Current IFTA Permits (Name and Account Number)

State of Operation:
All Units Travel Above:	Yes No
Bulk Fuel:	Yes No
Private: For Hire: ICC#: