Free WI IRP Application Schedule A - Wisconsin

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WI IRP APPLICATION SCHEDULE A
MV2914
Account No

Application Number ­ Office Use Only

10/2003
Fleet No Start Date Registrant Name

WI
U.S. DOT Number Contact Person ­ Regarding Application

Wisconsin Department of Transportation ­ IRP Unit PO Box 7955 Area Code ­ FAX Number Madison, WI 53707-7955 Telephone: 608-266-9900
Area Code - Telephone Number

E-Mail: [email protected]

FAX to 608-267-6886
Additions:
TYPE CODE TT ­ Truck Tractor TK ­ Straight Truck
UNIT EQUIP NO (1) Y E A R (2) MAKE (3)

If you have a STRAIGHT TRUCK, does it pull a FULL TRAILER?
HS ­ Hot Shot BS ­ Bus
VEHICLE IDENTIFICATION NO (4)

RT ­ Road Tractor WR ­ Wrecker
T Y P E (5) A X L E S (6) S E A T S (7) F U E L (8) UNLADEN WT (9)

No Yes, then list BOTH the gross and combination (Comb) weights.
GROSS WT (10) COMB GW (11) TITLED OWNER NAME (IF LEASED) (12) PURCHASE DATE MO/YR (13) OWNER PURCHASE PRICE (14) FACTORY LIST PRICE (15)

Deletions:

Apportioned power unit plates are transferred in the order listed. Cab cards for deleted vehicles must be returned within 15 days.
Cab card will be returned to WIDOT
LICENSED WT
(19)

Cab card has been lost or destroyed
UNIT EQUIP NO (17) VEHICLE IDENTIFICATION NO (18)

Replacement Cab Card/Plates ­ When applying for replacement cab card(s) and/or plate(s), complete the deletion section. A billing will be mailed to you. Replacement Cab Card Only $3.00 Replacement License Plate (and cab card) $6.00

APPORTIONED PLATE NO
(20)

NEED NEW PLATE
(21)

REASON REMOVED (22)

Instructions
1
A vehicle deleted using replacement credit cannot be re-added into the same fleet using replacement credit. The vehicle must be added as a straight addition (NO replacement credit allowed). You have 3 working days from date of operation to cancel or change an application. License plate(s) on replacement credit applications will be legal for transfer when you have received the cab card for the added vehicle.

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