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Owner-Operator Dispatch Service Application
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Blank Form (#3)
Driver/Owner Information
Full Name:
Company Name (if any):
Phone Number:
Email Address:
Preferred Contact Method (Phone / Email / Text):
Truck & Trailer Details
Truck Type *
Dry Van
Reefer
Flatbed
Power Only
Hotshot
Box Truck
Trailer Type (if applicable):
Year/Make/Model:
DOT Number:
MC Number:
TWIC Card:
Yes
No
Required Documents Upload
Please provide copies of the following (upload or send to info@reallogisticsusa.com):
W-9
Choose File
Certificate of Insurance (COI):
Choose File
Copy of CDL
Choose File
Signed Carrier Agreement (we will send after this form)
Choose File
Voided Check or Bank Letter (for direct deposit)
Choose File
Service Preferences
Regions You Prefer to Run:
Average Weekly Miles Desired:
Home Time Needed:*
Home Time Needed:*
Minimum Rate Per Mile You Accept:
Are You Currently Working with a Dispatcher?
Yes
No
Additional Notes or Special Requirements
Agreement
By submitting this application, I confirm that the information provided is accurate. I understand that Real Logistics will contact me to discuss onboarding and dispatch services.
Signature:
Choose File
Date:
Submit Form
