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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

Equipment Type
A
B
C
D

Preferred Lanes (States/Regions)

Home Base Location

Maximum Miles per Week

SECTION D — FACTORING

Use factoring?

Use factoring?
A
B

Factoring Company Name

SECTION E — DOCUMENTS

Certificate of Insurance

W9 Form

MC Authority

SECTION F — AGREEMENTS

Untitled checkboxes field