Fax #

Contact Email

Federal ID

USDOT #

Insurance Coverage

TRUCK/TRACTOR INFORMATION

Unit #

Registered Weight

Year

Make

Plate #

# of Axles

VIN #

TRAILER INFORMATION

Unit #

Year

Make

Plate #

# of Axles

VIN #

DIMENSIONS AND WEIGHT

Load Description

in

IF YOU ARE AN EXISTING RITE-WAY CUSTOMER IT IS NOT NECESSARY TO COMPLETE THE CUSTOMER INFORMATION.

ADDITIONAL INFORMATION

Length of Power Unit

ft

in

Trailer Length

ft

in

Trailer Width

ft

in

Deck Height

ft

in

Trailer Underclearence

ft

in

Tire Width

in

Tire Size

King Pin Setting

ft

in

Driver's Name

Driver's License

Driver's Fax #

AXLE CONFIGURATION AND TIRE INFORMATION

Axle Number

Steer 

2

3

4

5

6

7

8

Axle Weight

Tire Ratings

Axle Spacings (ft)/(in)

Requested Start Date

Comments