Annual Special Weight Vehicle Registration And Or Quarterly Billing Authorization Application {M-211}

Annual Special Weight Vehicle Registration and/or Quarterly Billing Authorization Guidelines WHO SHOULD FILE You should file this form if you are operating any vehicle, or combination of vehicles, having a total gross weight over eighty thousand (80,000) pounds, but no more than one hundred thirtyfour thousand (134,000) pounds, and you want a permit to travel on designated "extra heavy duty highways." These kinds of vehicles are commonly referred to as "Michigan Trains". File this Form M-211 to: (1) Register annually, and; (2) Pay a $25 registration fee. After filing this form, you must also: (3) receive & install a transponder in the vehicle, and; (4) obtain a special weight permit to travel on an extra heavy duty highway (designated routes). NOTE: Once we receive and process your registration form we will send you information concerning transponders. FIRST TIME APPLICANTS If this is the first time that you have registered an oversized or overweight vehicle in Indiana, you will need to complete a Transporting Agreement, Form M-203. SECTION A Complete lines 1 through 10 making sure that the information matches the company information on your Transporting Company Agreement, Form M-203. Pay special attention to line 8, and make sure the Federal Employer Identification Number (FEIN) is correct. NOTE: If you are a sole proprietor not required by federal law to obtain an FEIN, you must enter your social security number here. SECTION B Enter the make of tractor and serial number for each vehicle you are registering. The serial number is the last five (5) digits of the vehicle identification number (VIN). SECTION C Carriers are allowed to pay for their permits quarterly, rather than each time they order a permit. If you want to pay for your permits quarterly, check the box in Section C on the face of this return and provide a bond. The bond amount must equal or exceed the maximum estimated number of special weight trip authorization permits that will be ordered during any calendar quarter, times $42.50. The bond must be in effect for the entire calendar year. Use Form M-219 to secure your bond. PERMIT REQUESTS Once you have a Transporting Company Agreement (Form M-203) on file and have filed this form, Form M-211, you may request special weight trip authorization permits by either faxing your permit request to (317) 821-2336 or ordering online electronically. PERMIT FEES The annual registration fee for Special Weight Vehicles is $25 per company. The Trip Authorizations are $42.50 per movement and are paid either at the time the permit is requested, or on a quarterly basis. See the instructions for Section C if you are interested in quarterly payment provisions. Otherwise, you must pay for permits at the time the permit is requested. PENALTIES If a person is apprehended operating a vehicle(s) with an excess weight, the vehicle(s) may be detained, pending compliance, and a bond may have to be posted until all fines and costs are paid. Repeated violations may result in suspension from the use of the highways, and revocation of other licenses, certificates, and operating privileges. Consult your Oversized/Overweight Vehicle Permitting handbook or Indiana law for more details on violations and penalties. Mail this form, and your annual registration fee of $25 to: Indiana Department of Revenue OS/OW Section 7811 Milhouse Road, Suite M Indianapolis, IN 46241-9612 American LegalNet, Inc. www.FormsWorkFlow.com FORM M-211 State Form 47864 Revised (R4 / 10-12) Indiana Department of Revenue Annual Special Weight Vehicle Registration and/or Quarterly Billing Authorization Application Important: All Special Weight ("Michigan Train") carriers must register annually. See Guidelines on the back of this form. Section A (Must be completed by all Special Weight Carriers) 1) Company Name 4) Company Address 8) FEIN 2) Telephone Number 5) City 9) Calendar Year 3) Fax Number 6) State 7) Zip Code 10) USDOT Number Section B (Must be completed by all Special Weight Carriers) Enter the vehicles you are registering. We need this information in order to ensure that you have the required transponders in your vehicle(s). List each tractor you are registering and the serial number below. Attach additional sheets, if necessary. Make Year State Plate Number VIN Nick Name Section C Special Weight Carriers who wish to pay for their permits quarterly need to check this box to indicate that you are requesting quarterly billing authorization. To pay your permit quarterly, you must have a bond on file with the Indiana Department of Revenue Motor Carrier Services, Oversize Overweight section. Under penalties of perjury, I declare that I have examined this document and to the best of my knowledge it is true, correct, and complete. Annual Fee Due: $25 Please include your check, payable to the Indiana Department of Revenue. ______________________________________________ Signature of Responsible Officer Date American LegalNet, Inc. www.FormsWorkFlow.com