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 }

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

{~ 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-number-label'] }}: {binding displayValue}

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

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

{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}

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

{binding displayValue}

Company Information

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

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)

SELECT DEACTIVATION OPTIONS: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

DOT Number Only:
If you only have a DOT number you may deactivate it

MC Number/Authority:
If you have an MC number (aka authority) you will need revoke and detach it as well.

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

{binding displayValue}

Deactivation Processing Fee {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

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

{binding displayValue}

Signature {{ Cognito.resources["required-asterisk"] }} , { 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}

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

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

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

{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}

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

{binding displayValue}

Company Information

{~ Payment_Block_Label}

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

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

Company Information

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

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

Company Information