CustomPermits.com

 
 

Oversized Permits

Fill out all applicable information. Incomplete forms will slow permit processing.

Contact Information
First Name Last Name
Email Address
Work Phone Ext Phone Other

123-456-7890
Fax  
 
   
Carrier Information
Legal Name

Individual or Company name
ending in Inc, Ltd, LLC, etc.
DBA
Doing Business As
Physical Address
Mailing Address
City
State
Postal Code
   
ICC #

DOT #

 
Insurance Information
Insurance Carrier Name
Address 1
Address 2
City
State
Postal Code
     
Policy #
Date Effective
Expiration Date
   
Tax ID Number (FID/SS)
For security reasons, we will contact you for your Tax ID Number.
     
Power Unit Information
Driver's Name
 
Unit # Year Make  
 
 
Serial Number/VIN (All Caps) License Plate # /State
     
Empty Weight Registered GVW # Axles
 
Trailer Information
Unit # Year Make
Serial Number/VIN License Plate #/State

 (ALL CAPS)
 
 
No. of Axles Empty Weight Kingpin Setting
Trailer Dimensions  
L W H  
 
Load Information
Load Description

Include Make, Model & Serial Number
     
Load Weight Load Dimensions
L W H
     
Overall Dimensions & Weights
 (Truck/Tractor, Trailer & Load)
Overall L W H
Overhang Rear Front
 
Total Gross Weight Total # Axles  
 
     
Axle Spacings Axle Weights Tire Width No. of Tires
1-2 1 1 1
2-3 2 2 2
3-4 3 3 3
4-5 4 4 4
5-6 5 5 5
6-7 6 6 6
7-8 7 7 7
8-9 8 8 8
9-10 9 9 9
10-11 10 10 10
11-12 11 11 11
12-13 12 12 12
13-14 13 13 13
14-15

14

 14 14
15-16 15 15 15

16-17

 16 16 16
17-18 17 17 17
18-19 18 18 18
19-20 19 19 19
    20 20 20
 
Routing Information
Load Origin
Physical Address
City
State
 
Load Destination
Physical Address
City
State
 
State Route Eff. Date
 
State Route Eff. Date
 
State Route Eff. Date
 
State Route Eff. Date
 
State Route Eff. Date
 
State Route Eff. Date
 
State Route Eff. Date
 
State Route Eff. Date
 
State Route Eff. Date
 
State Route Eff. Date
 
State Route Eff. Date
 
State Route Eff. Date
 
Billing Information
Required only if different from company address.
Billing Name
Billing Address
 
City
State
Postal Code
   
Payment Information

For security reasons, we will contact you for your credit card information.

For alternate payment methods, please contact our office or enter additional information below.
 
Additional Information

Hours of Operation
Monday-Friday 7:30am-8:00pm EDT
Contact Information
Custom Permit Service Co.
2400 Briggs Rd, Suite 3
Columbus, OH 43223

Phone: 800-669-5014 or 614-351-1740
Fax: 614-351-1744
E-mail: permits@custompermits.com

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