Georgia Intrastate Motor Carrier Registration (GIMC) - Georgia Carrier Registration Only

Note: If you are an Interstate Carrier (cross state line), please register UCR only at www.ucr.in.gov
 
Business Officer First Name  
Business Officer Last Name  
Business Legal Name  
Doing Business Under The Following Name(DBA)
USDOT Number
Federal Employer Identification Number (EIN)
State Tax Id
Classification - Check all that apply
For Hire   Private   Motor Carrier Transporting Hazardous Materials  
Bus/Motorcoach   Wrecker/Towing Company   Household Goods  
Broker   Leasing Company   Freight Forwarder
Business Street  
Business City  
Business State  
Zip Code  
Check this box if Business Address and Mailing Address are the same.
Business Mailing Street
Business Mailing City
Business Mailing State
Zip Code
Telephone Number
Cell Phone Number
Fax Number
Email Address    
(Retype Email Address)