Driver Log & Qualification Review sign-up form

PLEASE PRINT OUT THIS SIGN-UP FORM
This is not a secure document. For your protection, print out the form and send it to us by:

MAIL: Tran Services, PO Box 898, Milford, DE 19963
FAX: 1-800-367-0019 24 hours a day, 7 days a week
CALL with the info: 1-800-367-9100 Mon - Fri, 8:00 a.m. - 5:00 p.m. eastern time

Continuous Monthly Driver's Log Review Service - $20.00 per driver per month, $5.00 additional for verification of E-Z Pass Statements and an additional $5.00 for verification of monthly Vendor Fuel Statements (other than on-site bulk tanks) and/or Trip Sheets.

Pre-pay for the first month's service and you will be billed for the number of drivers processed each month thereafter.

Continuous Monthly Driver Qualification Review - Initial set-up-$25.00 per driver for Non-CDL Drivers; $35.00 per driver for CDL Drivers.
Pre-pay for the initial service. Then $7.50 per driver each month thereafter, to maintain the driver's file.

Please complete the information below:

Number of drivers: ________ Type of commodity transported: _______________________________________

What recap system do your drivers use? 60 hours in 7 days ___________ 70 hours in 8 days___________

Number of vehicles: over 10,000 pounds gvwr ___________ over 26,000 pounds gvwr ___________

Are your trucks equipped with sleepers? Yes ___________ No ___________

Company Name _____________________________________________________________________________

Contact Person ______________________________________________________________________________

Mailing Address______________________________________________________________________________

City _____________________________________________________________ State _____ Zip ____________

Area Code & Phone No. _______________________________________________________________________

Area Code & Fax No. _________________________________________________________________________

TERMS: (Make checks payable to Tran Services) #_______________

Account No. (All digits) __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Expiration Date __ __/__ __/__ __

_____________________________________________________________________________
Signature required if using credit card

_____________________________________________________________________________
Please print name

NOTICE: Upon receipt of logs, toll receipts, and driver qualification files, we will perform the audit.
Upon completion of the audit, we will return the logs, toll receipts, qualification files,
and submit the audit reports and management reports to you.

1-800-367-9100 1-800-367-0019 Fax