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CARRIER ONBOARDING FORM

Please complete the following details to start dispatch services.

SECTION A — COMPANY DETAILS

1. Legal Company Name

2. DBA Name (Optional)

3. MC Number

4. DOT Number

5. FEIN / EIN

SECTION B — CONTACT DETAILS

Primary Contact Name

Email

Phone

By providing your phone number, you agree to receive text messages from Atlas Dispatch Partners LLC. Message and data rates may apply. Message frequency varies. Reply STOP to opt-out or HELP for help. View our [Privacy Policy] and [Terms of Service].

SECTION C — OPERATIONS

Number of Trucks

Equipment Type

Dry Van

Reefer

Flatbed

Other

Preferred Lanes (States/Regions)

Home Base Location

Maximum Miles per Week

SECTION D — FACTORING

Use factoring?

Yes

Factoring Company Name

SECTION E — DOCUMENTS

Certificate of Insurance

Size limit: 10 MB

W9 Form

Size limit: 10 MB

MC Authority

Size limit: 10 MB

SECTION F — AGREEMENTS

Untitled checkboxes field

I confirm I am authorized

I agree to Terms of Service

I agree to Privacy Policy