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CARRIER PACKET
First name*
Last name*
Date*
Email*
Company Name or DBA*
Preferred Method of Contact*
Phone
Email
MC#*
DOT#*
What type of trailer(s) do you have? (including dimensions & equipment you have)*
How many Trucks do you have?*
Do you have a Factoring Company?
Yes
No
If "NO", how do you intend to get paid?
Factoring Company Name
Factoring Company Number
Driver(s) Name(s)
Preferred Geographical Lanes
Southern States
West Coast States
MidWest States
SouthEastern States
NorthEastern States
Zones to AVOID
Zone 0
Zone 1
Zone 2
Zone 3
Zone 4
Zone 5
Zone 6
Zone 7
Zone 8
Zone 9
List any preferred lane details
Break Even Point
Max Load Capacity
Email address to receive invoices from Wealthy Cargo Solutions
Insurance Company (Copy of original certificate will be requested)
Agent and Contact Information
Starting Location(s)
How long have you had your authority?
Submit
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