Indiana > Statewide > Department Of Revenue > Motor Carrier
Application For Yard Tractor Permit YT-1 - Indiana
| Application For Yard Tractor Permit Form. This is a Indiana form and can be used in Motor Carrier Department Of Revenue Statewide . |
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State Form 47692 (R2 / 8-12) YT-1 Form Application For Yard Tractor Permit Annual Permit Fee: $40.00 IFTA Motor Account Number: IRP Account Number: US DOT Number: State: Zip Code: County: Federal Identification or Social Security Number: TID: Indiana Department of Revenue Company Name: DBA Name: Address: City: Telephone Number: Address of Terminal Locations (Indiana Only) Terminal #1 Terminal #2 Terminal #3 Terminal #4 Address: Address: Address: Address: City: City: City: City: This Yard Tractor Permit is an annual permit and applies to all yard tractors operated by the named carrier. This permit is not transferable to another carrier. Under no circumstances does this permit allow the carrier to carry cargo or transport or draw a semitrailer or other vehicle under the permit. A carrier may operate a yard tractor under the permit instead of paying tax imposed under this chapter. Yard tractor refers to a tractor that is used to move semitrailers around a terminal or a loading or spotting facility. Any person in violation of the strict authorization granted by the above requested permit may be subject to fines, impoundment of all vehicles in violation and revocation of all operating permits issued by the Department. American LegalNet, Inc. www.FormsWorkFlow.com Application For Yard Tractor Plates Plate Fee: $5.00 Number of Plate(s) Requested: ...................................................................................................................... $ ________________ Multiplied by $5.00 Plate Fee:......................................................................................................................... $ X 5.00 Equals Total Plate Fee: ................................................................................................................................... $ ________________ The Yard Tractor plate is to be displayed on a yard tractor. The plate can be transferred between yard tractors operated by the carrier. The yard tractor must be designated as a yard tractor permitted to operate on a public highway. Under no circumstances does this plate allow the carrier to carry cargo or transport or draw a semitrailer or other vehicle on a public highway. Any person in violation of the strict authorization granted by the carrier requested plate(s) may be subject to fines, impoundment of all vehicles in violation and revocation of all operating plates issued by the Department. Summary of Fees Due Annual Permit Fee Due:.................................................................................................................................. $ Total Plate Fee(s) Due: ................................................................................................................................... $ Total Fee(s) Due: ............................................................................................................................................ $ Please make Check or Money order payable to the Indiana Department of Revenue. Under penalty of perjury, I declare that I have examined this Yard Tractor application and to the best of my knowledge and belief it is true, correct and complete. I further declare that I will distribute the Yard Tractor permit issued to me by the Indiana Department of Revenue only in vehicles that I am operating or causing to be operated. Taxpayer or Authorized Agent: Typed or Printed Name: Date Signed: Title: Telephone Number: 40.00 .00 .00 You may submit the form by: Fax (317) 615-7310 Email IndianaIRP@dor.in.gov Mail Indiana Department of Revenue Motor Carrier Services - Attn: IRP Unit 7811 Milhouse Road, Suite M Indianapolis, IN 46241-9550 American LegalNet, Inc. www.FormsWorkFlow.com
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