STARTUP Bundle for $375 down

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Factoring | IFTA | DOT Compliance | Permits | Authorities | Insurance | Dispatch

STARTUP Bundle for $375 down

It takes a lot of money to start your own business. Your goal is to get on the road and start making money

legally! Meeting DOT requirements so you don’t risk being put out of service can be costly and confusing. Our

goal is to eliminate the confusion and expedite the process.

Services in this package include:

MC Number Motor carrier number for Interstate operations

BOC-3 Process agent listing in every state

UCR Unified Carrier Registration

DIY Compliance Package Industry leader in Compliance services

Authority Letter MC Letter

Consortium Enrollment Random Drug/Alcohol testing pool

Compliance Webinar What you need to know to get started

Roadside Masters Membership Emergency roadside assistance (free for two months)

Access to our in-house team of experts

* The BOC-3 will not be filed until the complete Factoring Application has been received by our Underwriting Team

The UCR & Consortium will not be completed until you have insurance on file and are active. *

Cost to obtain above services…………………………………………………………………$775

A down-payment of $375 to Truckers Bookkeeping to get started……… -$375

Remaining balance paid through factored loads over 4 weeks…………… $400

This bundle package may not include all the permits you may need.

Find all permits we offer by going to www.truckersbookkeepingservice.com

How Does It Work? TBS Factoring Service, LLC pays the funds upfront to minimize your out - of -pocket costs.

When you start running, we will start deducting $100 a week from your factored loads for 4 weeks beginning

the 5th week after your authority was filed. Your authority should be active in 3 weeks from the filing date

(this can only happen if your insurance is in place within the first 2 weeks.)

TBS Insurance Agency also has a deferred down-payment program to make your out-of-pocket expenditures

more manageable. Call today and ask for our Insurance Agency!

Independents choose TBS for a reason. We Are Your One-Stop Shop.

Mailing Address: Phone: 800-207-7661

P.O. Box 18109 405-528-4490

Oklahoma City, OK 73154 Fax: 405-576-3098

Email: [email protected]

http://www.truckersbookkeepingservice.com/

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So that we can start processing your bundle, please complete this form in its entirety.

This form completes the purchase and allows both companies to begin preparing your documents.

Company Info __ Company Name (Full Legal Name) DBA Please send your certificate AND Articles for LLC/Inc/Partnership

Contact Name: ______________________________________________Phone: _______________________________

Physical Address

City

State

Zip

Billing Address

City

State

Zip

Telephone (Include Area code)

Fax (Include Area code)

Cell Phone (Include Area code)

Federal ID Number

Company Owners/Members:

DOT Number & Pin (leave blank if none)

Must have an E-Mail to file MC

First Name (First, Middle, Last)

Title

Ownership %

Home Address

City, State, Zip Code

____ Rent ____ Own

Home Phone

Social Security Number

Date of Birth

Place of Birth (State & Country)

Driver’s License Number

Issuing State

Expiration Date

Second Name (First, Middle, Last)

Title

Ownership %

Home Address

City, State, Zip Code

____ Rent ____ Own

Home Phone

Social Security Number

Date of Birth Place of Birth (State & Country)

Drivers License Number Issuing State Expiration Date

Please list each owner or member of the company above. How did you hear about the TBS Companies? __________________________________________________________________________________

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Have you ever factored before? ________________ If yes, with what company and when? _____________________________________________

Have you ever had a MC or DOT authority before? ____________________________________

Previous MC # _______________________________ and DOT #: _________________________

Form of Business: ______ Sole Proprietor ______ Corporation/What state ______ ______ Partnership ______ Trusts ______ Limited Liability Partnership/What State: ______ ______ Limited Liability Company/What State: _________ ______

Other (Please specify) ________________________________________________________________

How many trucks on your authority are UNDER 10,000 lbs ___________ How many trucks OVER 10,001 lbs.? __________

How many trucks do you OWN? __________ Mark what kind of trucks you own: Straight Trucks_____ Truck Tractors_____ Trailers ________ How many Drivers? _____ How many CDL drivers? ________

How many are Leased on to your authority? _________ Straight Trucks______ Truck Tractors ______ Trailers ____________

Operation Classification: For-Hire _____________ Broker: ______________ Freight Forwarder: ______________

Cargo: Most cargo will fall under General Freight… The more you check, the more your insurance will cost ______ General Freight ______ Metal: Sheets, Coils, Rolls ______ Motor Vehicles/Drive away - Tow away

______ Commodities/Dry Bulk ______ Building Materials ______ Mobile Homes

______ Refrigerated Foods ______ Oil Field Equipment ______ Machinery/Large Objects

______ Beverages ______ Intermodal ______ Fresh Produce ______

Construction ______ Paper Products ______ Other ___________________________ ****Anything with a combustible engine is Class 9 Hazmat/DOT Requires $1,000,000 Liability*****

I/We understand that the submission of an application for factoring with TBS Factoring Service, LLC does not mean that TBS Factoring Service, LLC

will factor or provide any financial services whatsoever. I/We further understand that approval to factor may come ONLY after the Board of

Directors of TBS Factoring Service, LLC, approves the application, invoices, and accounts offered in accordance with TBS Factoring Service, LLC’s

policies. The above statements are true and correct to the best of my knowledge and belief. By signing this document, I/We consent to and

authorize TBS Factoring Service, LLC to request and obtain any information or documentation necessary to process this application, including, but

not limited to, any information needed to conduct a credit investigation. Client hereby grants, as security for the timely performance of all of Client’s obligations under this Agreement and the payments due TBS under this

Agreement, a security interest in the following property of Client: All presently existing or hereafter arising, now owned or hereafter acquired accounts, accounts receivable, contract rights, documents, reserves,

reserve accounts, rebates, and general intangibles, and all books and records pertaining to accounts and all proceeds of the foregoing property (the

Collateral) Client hereby authorizes TBS to perfect a lien against the Collateral in favor of TBS and Client further authorizes TBS to file a UCC-1

Financing Statement wherever TBS desires without the Client’s signature or further authorization. Client further authorizes TBS to file any other

documents which TBS may deem necessary to perfect or evidence its security interest in the Collateral.

Owner/Member

__________________________________________________________________________________________________ Signature Title Date

Owner/Member

_____

Signature Title Date

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I.DRIVER QUALIFICATIONS

1.

Does the Applicant certify it was in place a system and procedures for ensuring the continued qualification of drivers to operate safely, including a safety record for each driver, procedures for verification of proper age and licensing of each driver, and procedures for identifying drivers who are not complying with the FMCSRs (Federal Motor Carrier Safety Regulations), and a description of a retraining and educational program for poorly performing drivers?

2. Does the Applicant certify it has procedures in place to review drivers’ employment and driving histories for at least the last 3 years, to determine whether the individual is qualified and competent to drive safely?

3. Does the Applicant certify it has established a program to review the records of each driver at least once every twelve (12) months and will maintain a record of the review?

4. Does the Applicant certify it will ensure, once operations in the United States have begun, that all of its drivers operating in the United States are at least 21 years of age and possess the appropriate licensing for the type of vehicle and commodity being transported?

II. HOURS OF SERVICE

1. Does the Applicant certify it has in place a record keeping system and procedures to monitor the hours-of-service performed by drivers, including procedures for continuing review of drivers’ log books, and for ensuring compliance with all operations requirements?

2. Does the Applicant certify it has ensured that all drivers to be used in the United States are knowledgeable of the United States’ hours-of-service requirements under 49 CFR Part 395, as well as the requirement for preparing daily log entries in their own handwriting for each 24-hour period?

3. Does the Applicant certify it will ensure, once operations in the United States have begun, that its drivers operate within the hours-of-service rules and are not fatigued while on duty?

III. DRUG AND ALCOHOL (To be completed by motor carriers subject to drug and alcohol testing only)

1. Does the applicant operate Commercial Motor Vehicles as defined in 49 CFR 382.107 and 49 CFR 383.5?

2. Does the Applicant certify it is familiar with the alcohol and controlled substance testing requirements of 49 CFR part 382 and 49 CFR part 40 and has in place a program for systematic testing of drivers?

IV. VEHICLES

1. Does the Applicant certify if the carrier has established a system and procedures for inspection, repair and maintenance of its vehicles in a safe condition, and for preparation and maintenance of records of inspection, repair, and maintenance in accordance with the U.S. DOT’s Federal Motor Carrier Safety Regulations and, if applicable, the Federal Hazardous Materials Regulations and the Federal Commercial Regulations?

2. Does the Applicant certify if the carrier has inspected all vehicles that will be used in the United States before the beginning of such operations and has proof of the inspection on board the vehicle as required by 49 CFR 396.17?

3. Does the Applicant certify it will ensure, once operations in the United States have begun, that all vehicles it operates in the United States were manufactured or have been retrofitted in compliance with the applicable U.S. DOT Federal Motor Vehicle Safety Standards or Canadian Motor Vehicle Safety Standards in effect at the time of manufacture?

4. Does the Applicant certify it will ensure, once operations in the United States have begun, that all violations and defects noted on the inspection reports are corrected before vehicle and drivers are permitted to enter the United States?

5. Does the Applicant certify it will ensure that all vehicles operated in the United States are inspected at least every 90 days by a certified inspector in accordance with the requirements for a Level II Inspection under the criteria of the North American Standard Inspection, as defined in 49 CFR 350.105, once operations in the United States begin and until such time as the

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carrier has held permanent registration from the FMCSA for at least 36 consecutive months? After the 36-month period expires, the carrier will ensure that all vehicles operated in the United States are inspected in accordance with 49 CFR 396.17 at least once every 12 months thereafter.

V. ACCIDENT MONITORING

1. Does the Applicant certify that the carrier has in place a program for monitoring vehicle accidents and it maintains an accident register in accordance with 49 CFR 390.15?

2. Does the Applicant certify that the carrier has established an accident countermeasures program and driver training program to reduce accidents?

VI. PRODUCTION OF RECORDS

1. Does the Applicant certify that the carrier can and will produce records demonstrating compliance with the safety requirements within 48 hours of receipt of a request from a representative of the U.S. DOT/FMCSA or other authorized Federal or State official?

2. Please upload a document stating the Full Name (First Name and Last Name), and Address of individual(s) is directed by applicant to respond to inquiries for records.

VII. HAZARDOUS MATERIALS (To be completed by motor carriers of hazardous materials only)

1. Does the Applicant certify that the HM carrier has full knowledge of the U.S. DOT Hazardous Materials Regulations, and has established programs for the thorough training of its personnel as required under 49 CFR part 172, Subpart H and 49 CFR 177.816?

2. The HM carrier has attached to this application a statement providing information concerning: (1) the names of employees responsible for ensuring compliance with HM regulations, (2) a description of their HM safety functions, and (3) a copy of the information used to provide HM training.

3. Does the Applicant certify that the HM carrier has established a system and procedures for filling and maintaining HM shipping documents?

4. Does the Applicant certify that the HM carrier has a system in place to ensure that all HM trucks are marked and placarded as required by 49 CFR part 172, subparts D and F?

5. Does the Applicant certify the carrier will register under 49 CFR part 107, subpart G, if transporting any quantity of hazardous materials requiring the vehicle to be placarded?

TO BE COMPLETED BY CARGO TANK (CT) MOTOR CARRIERS OF HAZARDOUS MATERIALS (HM):

6. Does the Applicant certify the carrier will submit with this application, certificates of compliance for each cargo tank the company utilizes in the U.S., together with the name, qualifications, Cargo Tank (CT) Facility number, and CT Facility number registration statement of the facility it will be utilizing to conduct the test and inspections of such tanks as required by 49 CFR part 180?

COMPLIANCE CERTIFICATIONS

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 authority granted.

1. Does the Applicant certify 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?

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2. Does the Applicant certify 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?

3. Does the Applicant certify it is not currently disqualified from operating commercial motor vehicles in the United States?

4. Does the Applicant certify 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 the receipt of filings and notices issued in connection with the enforcement of any Federal statutes or regulations?

5. Does the Applicant certify 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?

6.

Does the Applicant certify it has paid all taxes owed under section 4481 of the U.S. Internal Revenue Service (26 U.S.C. & 4481) for the most recent taxable period as defined under section 4482(c) of the Internal Revenue Code?

NOTE: All motor carriers operating within the United States, including foreign-domiciled motor carriers applying for USDOT registration by this form, must comply with all applicable Federal, State, local, and tribal statutory and regulatory requirements when operating within the United States. Such requirements include, but are not limited to, all applicable statutory and regulatory requirements administered by the U.S. Department of Labor, or by an OSHA State plan agency pursuant to section 18 of the Occupational Safety and Health Act of 1970. Such requirements also include all applicable statutory and regulatory environmental standards and requirements administered by the U.S. Environmental Protection Agency or a State, local or tribal environmental protection agency. Compliance with these statutory and regulatory requirements may require motor carriers and/or individual operators to produce documents for review and inspection for the purpose of determining compliance with such statutes and regulations.

Please read all of the above, you are verifying you understand: Yes, I Certify that ALL of the above are accurate

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APPLICANT’S OATH

This oath applies to all supplemental filings to this application. The Signature must be that of an authorized official of the applicant, not the legal representative.

I, ________________________________________________, verify under penalty of perjury, under the laws of the United States of (PRINT NAME) America, 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 of 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 of up to $250,000 or imprisonment of 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. 862). Signature ______________________________ Title _________________________________________ Date ___________________

CERTIFICATION STATEMENT (to be completed by the applicant)

I, __________________________________________, certify that I am familiar with the Federal Motor Carrier Safety Regulations,

and, (Please Print Name)

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).

Signature __________________________________ Date _____________________ Title __________________________________

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LIMITED POWER OF ATTORNEY

TO ALL PERSONS, be it known, that I, ___________________________, (“INDIVIDUAL”)

individually and on behalf of ____________________________________________________

(“COMPANY”) as Grantor, do hereby make and grant a limited power of attorney to Truckers

Bookkeeping Service, LLC, Oklahoma City, Oklahoma (“TBS”) and TBS employees, which include

Linda Baggett, Jo Biddle, Berny Camberos, Aileen Cunliffe, Denise Duck, Mayra Franco, Tami

Gary, Dennis Kaufman, Wood Kaufman, Angela Little, Tasha Marshall, Amy Richardson, Stephanie

Smith, Gina Spurgeon, Mayra Tello, Cynthia Urbina, Conna Weaver & Carri Wright (“TBS

EMPLOYEES”), and appoint and constitute said entity, TBS, and individual persons, TBS

EMPLOYEES, as my Attorney-In-Fact, with full power and authority to sign reports and

applications, to receive correspondence, to appear on behalf of and represent COMPANY in any

administrative hearing or audit of the Oklahoma Tax Commission or any other governmental entity,

to pay taxes and fees on behalf of COMPANY, pertaining to fuel taxes, vehicle registrations and

titles, motor carrier authorities, motor vehicle permits, road use taxes, state business registrations,

state payroll withholdings, state unemployment insurance, state workers compensation insurance,

Oklahoma Secretary of State filings, any other state applications, or any other documents which

pertain to the above noted matters. In the event any of the above listed TBS EMPLOYEES terminate

employment with TBS, that individual person shall no longer be authorized to transact business for

COMPANY under this limited power of attorney. The authority granted shall include such incidental

acts as are reasonably required or necessary to carry out and perform the specific authorities and

duties stated or contemplated herein.

COMPANY and INDIVIDUAL acknowledge this power of attorney does not, in any way,

relieve or absolve COMPANY or INDIVIDUAL of its duties and responsibilities under applicable

law. In consideration for the duties to be performed by TBS and TBS EMPLOYEES under the terms

of this limited power of attorney, COMPANY and INDIVIDUAL, its successors and assigns, hereby

release TBS and TBS EMPLOYEES from all claims, disputes, causes of action and assessments that

may arise as a result of an audit, investigation, proceeding, or other action taken against the

COMPANY by the Oklahoma Tax Commission, other governmental agency, quasi-governmental

entity, person, or entity. Furthermore, if services are rendered under this power of attorney,

COMPANY and INDIVIDUAL promise to pay for such services no later than 30 days of the invoice

date. If fees for services rendered are not paid within 30 days, COMPANY and INDIVIDUAL may

be assessed additional fees for interest, collection costs, attorney fees, and court costs, and

COMPANY and INDIVIDUAL agree to pay such additional charges. This power of attorney and

agreement shall continue in full force and effect until revoked by subsequent writing.

Signature - INDIVIDUAL/Grantor____________________________________________________

Name, Position (please print) _________________________________________________________

COMPANY (please print)

____________________________________________________________

Date: ___________________

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Name: Return to fax: 405-488-1999

Fax #: Truckers Bookkeeping Service, L.L.C.

Client #: PO Box 18109

Attn: Oklahoma City, OK 73154

I hereby agree that Truckers Bookkeeping Service, L.L.C. (TBS) has or will be providing

the following services and/or goods described below:

Amount

Bundle, MC, DOT, BOC-3, UCR, DIY, Consort & MC Letter $900.00 **Be sure to check out our website for other permits you may need**

Client Down payment (-$375.00)

Balance $525 to be paid back at $105 a week starting the 5th week

AFTER the MC is applied for through factored loads with TBS Factoring

Service LLC

To pay by cashier’s check, pay this amount Subtotal $375.00

Service Fee 3.5% $13.13

Total $388.13

In consideration for the above charges, I authorize TBS to charge the below credit card:

Please print ALL of the following information: Client understands that if they stop Factoring and want

to pay the balance in full, there will be a $250 termination fee plus the Full remaining balance.

ALL MAJOR CREDIT CARDS ACCEPTED

1. Cardholders name: ___________________________________ (Not the bank name)

2. Type of card (visa, etc.): _______________ Expiration date_____________________

3. Card number: ___________________________________________________

4. 3-digit security number (last 3 on back of the credit card) ______________________

5. Credit card billing address _______________________________________________

________________________________________________________________________ Cardholder acknowledges receipt of goods and/or services in the amount of the Total shown hereon and agrees to

perform the obligations set forth in the Cardholder’s agreement with the Issuer.

X_______________________________________ Date: ___________________ Cardholder/Purchaser Sign Here

** The BOC-3 will not be filed until the complete Factoring application has been received from our Underwriting

Team**

** The UCR & Consortium will not be processed until you have insurance on file and are active. **

Ask about the other services we offer: Insurance, IRP, 2290 processing, Permits, Fuel Tax Reporting & Dispatching

Documents

STARTUP Bundle for $375 down