This application revokes and deactivates a U.S. DOT number in all agencies. Necessary paperwork will be filed with the FMCSA and the U.S. DOT to close your DOT number per FMCSA protocol.

 

Deactivation of you U.S. DOT number will release you from complying with FMCSA and U.S. DOT regulations. 

 

U.S. DOT numbers that are not deactivated are still subject to federal mandates and you may be penalized for noncompliance. 

Name of Person Completing this Order {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

Company Information

{ binding firstError.message }
Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

If you are not able to complete the required fields above, please fill them with "0" and check the box to the right and our agents will contact you to file your form using alternative method(s)

 

 

 

{ binding firstError.message }

MC Number/Authority:

If you have an MC# number (aka Motor Carrier Authority) you will need to revoke it and detach it as well. 

{ binding firstError.message }
{ binding firstError.message }

 

 

{ binding firstError.message }
{ binding firstError.message }
How would you like to receive confirmation? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

Please use your computer mouse (or finger if completing this application on your smartphone) to provide a signature.

{ binding firstError.message }

 

 

 

{ binding firstError.message }

If an agent has assisted you in filing this application please provide their code here. If no one assisted you with this application or you do not know your agent’s code please leave this field blank.

{~ Payment_Block_Label}

{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}---
{{ Cognito.resources['payment-amount-due'] + ":" }} {binding displayValue}

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{{ Cognito.resources['order-billing-info-header'] }}

{binding BillingName}
{binding BillingAddress.FullInternationalAddress}
{binding PhoneNumber}
{binding EmailAddress}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}

This application revokes and deactivates a U.S. DOT number in all agencies. Necessary paperwork will be filed with the FMCSA and the U.S. DOT to close your DOT number per FMCSA protocol.

 

Deactivation of you U.S. DOT number will release you from complying with FMCSA and U.S. DOT regulations. 

 

U.S. DOT numbers that are not deactivated are still subject to federal mandates and you may be penalized for noncompliance. 

Name of Person Completing this Order {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Title {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Company Information

Company Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
DOT Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

If you are not able to complete the required fields above, please fill them with "0" and check the box to the right and our agents will contact you to file your form using alternative method(s)

 

 

 

CLOSE MY DOT NUMBER {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

MC Number/Authority:

If you have an MC# number (aka Motor Carrier Authority) you will need to revoke it and detach it as well. 

CLOSE MY MC# ALSO {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
What is your MC#? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

 

{ binding firstError.message }
Deactivation Processing Fee {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
How would you like to receive confirmation? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

Please use your computer mouse (or finger if completing this application on your smartphone) to provide a signature.

Notes {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

 

 

Asst Agent {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{{ Cognito.resources['order-billing-info-header'] }}

{binding BillingName}
{binding BillingAddress.FullInternationalAddress}
{binding PhoneNumber}
{binding EmailAddress}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}

This application revokes and deactivates a U.S. DOT number in all agencies. Necessary paperwork will be filed with the FMCSA and the U.S. DOT to close your DOT number per FMCSA protocol.

 

Deactivation of you U.S. DOT number will release you from complying with FMCSA and U.S. DOT regulations. 

 

U.S. DOT numbers that are not deactivated are still subject to federal mandates and you may be penalized for noncompliance. 

Name of Person Completing this Order {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Title {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Company Information

Company Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
DOT Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

If you are not able to complete the required fields above, please fill them with "0" and check the box to the right and our agents will contact you to file your form using alternative method(s)

 

 

 

CLOSE MY DOT NUMBER {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

MC Number/Authority:

If you have an MC# number (aka Motor Carrier Authority) you will need to revoke it and detach it as well. 

CLOSE MY MC# ALSO {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
What is your MC#? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

 

{ binding firstError.message }
Deactivation Processing Fee {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
How would you like to receive confirmation? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

Please use your computer mouse (or finger if completing this application on your smartphone) to provide a signature.

Notes {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

 

 

Asst Agent {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }