New York highway use tax (NYHUT) Form

Step 1. Form Step 2. Payment

USDOT# Number:

Email address:

Business Phone Number:

Fax number:

Who is Filing the Form?

Legal name:

DBA:

EIN (if exists):

Suffix:

SSN (if exists):

Position of the form filler:

Business type:

Other business type:

Physical country:

Physical state (abbreviated):

Physical city:

Physical address:

Physical zip code:

Billing Address is the Same as Physical Address.

Billing country:

Billing state (abbreviated):

Billing city:

Billing address:

Billing zip code:

I certify that I am the authorized holder and signer of the credit card reference above. I certify that all information above is complete and accurate.

I hereby authorize collection of payment for all charges as indicated above. Charges may not exceed the amount listed above in the “TOTAL COST” field. I understand this is only for up to this amount on the date listed below in the "DATE SIGNED" field. If additional charges are going to be authorized a new form will have to be completed.

The “TOTAL COST” includes all Federal, State and Local Government fees.

I hereby, acknowledge and agree that after the charges are authorized a DOT OPERATIONS INC agent is assigned in 15 minutes to run the order. Once the agent is assigned the charges become non-refundable.

Signature:

I agree with Privacy Policy and Terms and conditions

Your signature:

Total cost: $ 0

New York highway use tax (NYHUT) Form

Vehicle details

Member details

Your signature: