MSC-150 Update – MASERVIGESTION CORPORATION

MSC-150 Update Form

Please complete the following information.

First Name

Last Name

Email Address

Contact Phone

Legal Business Name

Please upload Certificate of Formation / Incorporation

Choose File

Doing Business As (DBA) – If Applicable

Please upload IRS EIN / FEIN Confirmation Letter (CP 575 o 147C)

Choose File

Business Address

Address Line 1

City

State

Zip Code

Will you operate Commercial Motor Vehicles (CMV) with a GVWR over 10,001 lbs?

Yes

Repeater Field

USDOT NO.	MC OR MX NO.	DUN & BRADSTREET NO.	Carrier Mileage	Years

Vehicle Information

Number of Vehicle	Number of Driver	CDL Drivers	Class "D"

Company Operation (Select all that apply)

Interstate Carrier

Intrastate Hazmat Carrier

Intrastate No-Hazmat Carrier

Interstate Hazmat Shipper

Intrastate Hazmat Shipper

Vehicle Registrant Only

If Other, please specify

Please upload Government ID

Choose File

Base State

Authorized Person Name

Authorized Person Title

Owner

Member

Manager

President

Authorization Consent

I certify that the information provided is accurate and I authorize MASERVIGESTION CORPORATION to prepare and submit filings on my behalf with IRS, state agencies, and other authorities as required.