Your Name (required)

Your Email Address (required)

Your Phone Number (required)

Applicant Name (Individual or Corporation) (required)

President/Owner's Name (if a Corporation)

Title (President, Owner, Manager, etc.)

Address

Phone Number

Number of sets needed (1 set has two decals for each side of the truck)

I am aware that by submitting this form I give my permission to DL Freight Inc to complete the IFTA registration application on my behalf.*
Yes

Additional Notes (optional)