I certify that I am familiar with the Federal Motor Carrier Safety Regulations and, if applicable, the Federal Hazardous Materials Regulations, and the Federal Motor Carrier Commercial Regulations. Under penalties of perjury, under the laws of the United States of America, I certify that all information supplied on this form or relating to this application is true and correct. Further, I certify that I am qualified and authorized to file this application. I know that willful misstatements or omissions of material facts constitute Federal criminal violations punishable under 18 U.S.C. § 1001 by imprisonment up to 5 years and fines up to $250,000 for each offense. Additionally, these statements are punishable as perjury under 18 U.S.C. § 1621, which provides for fines up to $250,000 or imprisonment up to 5 years for each offense.
I further certify under penalty of perjury, under the laws of the United States, that I have not been convicted, after September 1, 1989, of any Federal or State offense involving the distribution or possession of a controlled substance, or that if I have been so convicted, I am not ineligible to receive Federal benefits, either by court order or operation of law, pursuant to Section 5301 of the Anti-Drug Abuse Act of 1988, formerly Pub. L. 100-690, Title V, Section 5301, Nov. 18, 1988, 102 Stat.4310, renumbered and amended Pub. L. 101-647, Title X, Section 1002(d), Nov. 29, 1990, 104 Stat. 4827 (21 U.S.C. § 826).
By signing these certifications, the certifying official is on notice that the representations made herein are subject to verification through inspections in the United States and through the request for examination of records and documents. Failure to support the representations contained in this application could form the basis of a proceeding to assess civil penalties and/or lead to the revocation of the registration granted.
Applicant certifies it is willing and able to provide the proposed operations or service and to comply with all pertinent statutory and regulatory requirements and regulations issued or administered by the U.S. Department of Transportation, including operational regulations, safety fitness requirements, motor vehicle safety standards and minimum financial responsibility and designation of process agent requirements.
Applicant certifies it is willing and able to produce for review or inspection documents which are requested for the purpose of determining compliance with applicable statutes and regulations administered by the Department of Transportation, including the Federal Motor Carrier Safety Regulations, Federal Motor Vehicle Safety Standards, Commercial Regulations, Hazardous Materials Regulations, and Americans With Disabilities Act regulations within 48 hours of any written request? Applicant understands that the written request for documents may be served on the contact person identified in the company contact section of this application, or the designated process agent?
Applicant certifies it is not currently disqualified from operating commercial motor vehicles in the United States.
Applicant certifies it understands that the agent(s) for service of process designation will be deemed the applicant’s official representative(s) in the United States for receipt of filings and notices in administrative proceedings under 49 U.S.C. § 13303, and for receipt of filings and notices issued in connection with the enforcement of any Federal statutes or regulations
Applicant certifies that the carrier is not prohibited from filing this application because its FMCSA registration is currently under suspension, or was revoked less than 30 days before filing the application.
If the Applicant’s registration is currently revoked, Applicant certifies the deficiencies cited in the revocation proceeding have been corrected?
As a user of Federal Motor Carrier Safety Administration Information Technology (FMCSA IT) Systems, I understand that I am personally responsible for my use and any misuse of my system account and password. FMCSA IT systems are the property of the Federal government. FMCSA owns the data stored on FMCSA databases, including all data recorded for monitoring, email messages and information, even those deemed personal. I understand that by accessing a U.S. government information system that I must comply with the following requirements:
1) Sensitive information may not be transmitted at a level higher than what the system is approved for.
2) Any activity that violates Federal laws for information protection (e.g., hacking, spamming, etc) is not permitted.
3) Any password compromise or unauthorized usage of the user accounts must be reported immediately to the FMCSA ISSO to the FMCSA ISSO at FMCSA Headquarters (MC-RIS).
I understand that Federal law provides for punishment under Title 18, U.S. Code, including a fine and up to 10 years in jail for the first offense for anyone who:
a) Knowingly accesses an information system without authorization, or exceeds authorized access, and obtains information that requires protection against unauthorized disclosure.
b) Intentionally, without authorization, accesses a government information system and impacts the government’s operation, including availability of that system.
b) Intentionally accesses a government information system without authorization, and alters, damages or destroys information therein.
My acceptance below indicates that I have read, understand, and will comply with these requirements as a condition of maintaining active accounts with access to FMCSA IT systems. I also understand that failure to comply with these requirements may result in disciplinary action.