VEHICLE INFORMATION SHEET

 

One per vehicle

All information must be completed in full!

 

 

Unit Number:______ Vehicle ID #:______________________________________

 

Year: ______ Make:__________  Model:_________________________________

 

Gross Vehicle Weight (GVW):_____________ Empty Weight:_________________

 

Number Of Axles: _________

 

What type of vehicle is this? (Circle One)  TT, TK, PW, or BUS

         (TT-Truck Tractor, TK-Straight Truck, PW-Wrecker)

 

(A)      Do you pull a trailer? _____Yes  _____ No

(B)      Type of fuel _________________________

 

State truck is base plated in ______________________

 

Plate # _____________________________________

Is this an Apportioned plate?          _____Yes _____ No

If yes, what is you IRP account number? _________________