Application Form

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Application Form

WASHINGTON METROPOLITAN AREA TRANSIT COMMISSION

1010 Wayne Avenue, Suite 1240

Silver Spring, MD 20910

(301) 588-5260

www.wmatc.gov

APPLICATION TO OBTAIN, TRANSFER, OR AMEND IRREGULAR ROUTE AUTHORITY

	USE THIS FORM to obtain, transfer, or amend authority to transport passengers for hire in motor vehicles over irregular routes between points in the Washington Metropolitan Area Transit District (Metropolitan District). A transfer of authority includes a merger, acquisition or other transfer of control over a carrier or a carrier’s assets or operations.
	THE METROPOLITAN DISTRICT consists of the following:
	* The District of Columbia;
	* Alexandria, Falls Church, Arlington County, and Fairfax County, Virginia, and the political subdivisions located therein;
	* Montgomery County and Prince George’s County, Maryland, and the political subdivisions located therein;
	* Washington Dulles International Airport; and
	* All other cities now or hereafter existing in Maryland or Virginia within the borders of the foregoing cities, counties, and airport.
	DO NOT USE THIS FORM to make a simple name change or to add a seating capacity restriction to an existing certificate or to obtain authority for passenger transportation solely in Virginia.
	INSTRUCTIONS
	1. Check type of application(s) below.
	2. Part I -- Read and complete.
	3. Part II – Upload Attachment A and if necessary, Attachment B.
	4. Part III – Read and submit Verification
	5. Pay filing fee(s). See below.
	Note: Application filing fees are in addition to any publication cost and costs associated with a hearing if one becomes necessary.

Filing Fee

TYPE OF APPLICATION (Check as Appropriate)*

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$300.00

Obtain Unrestricted Certificate of Authority - Operate any size vehicle ($5 million insurance)

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$300.00

Obtain Restricted Certificate of Authority - Operate only vehicles seating 15 persons or less ($1.5 million insurance)

$300.00

Transfer Certificate of WMATC No.

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$300.00

Transfer Control of WMATC No.

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$300.00

Remove Seating Capacity Restriction of WMATC No.

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$150.00

Obtain Temporary Authority

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$150.00

Obtain Temporary Approval of Transfer of Control

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Total Due

INVALID - Please check only one box.

PART 1

Applicant Information

Form of Business*

Please check one box.

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Select one option that describes applicant's form of business

Corporation

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LLC, LLP or LP

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Partnership

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Sole Proprietor

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Other

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Name and Address*

	Applicant's complete legal name, street address, and phone MUST be completed.*
	For transfer applications, the applicant is the one to whom authority is being transferred.
	A trade name is not required. If applicant wishes to conduct business under a name different from its legal name, indicate the trade name and include Attachment B.
	For more information about Attachments A and B, see Part 2.

Legal Name*	Invalid Input	(as it appears on attachment A) What's this?
Trade Name	Invalid Input	(as it appears on attachment B) What's this?

Street*	Invalid Input	Apt./Suite	Invalid Input
City*	Invalid Input
State*	Invalid Input
Zip*	Invalid Input

Mailing Address

Street	Invalid Input	Apt./Suite	Invalid Input
City	Invalid Input
State	Invalid Input
Zip	Invalid Input

Phone Number*	Invalid Input
Other Phone	Invalid Input
Fax Number	Invalid Input
Email*	Invalid Input

Contact

Please enter contact information - First Name, Last Name, Title, Street, City, State, Zip, Phone Number, and Email.

	Applicants other than sole proprietors MUST designate a representative to receive
	filings, inquiries and correspondence regarding this application.
	Sole proprietors may, but need not, designate a representative.

	Mr.Ms. Invalid Input
First Name	Invalid Input
Middle Name	Invalid Input
Last Name	Invalid Input
Title	Invalid Input
Street	Invalid Input	Apt./Suite	Invalid Input
City	Invalid Input
State	Invalid Input
Zip	Invalid Input

Phone Number	Invalid Input
Other Phone	Invalid Input
Fax Number	Invalid Input
Email	Invalid Input

Agent

	IF Applicant's place of business is outside the Metropolitan District, an agent must be designated
	inside the Metropolitan District to accept service on behalf of applicant.
	See page one for description of Metropolitan District. Please enter agent information - First Name, Last Name, Street, City, State, Zip, Phone Number, and Email.

	Mr.Ms. Invalid Input
First Name	Invalid Input
Middle Name	Invalid Input
Last Name	Invalid Input
Street	Invalid Input	Apt./Suite	Invalid Input
City	Invalid Input
State	Invalid Input
Zip	Invalid InputError. Your agent must be located inside the Metropolitan District.

Phone Number	Invalid Input
Other Phone	Invalid Input
Fax Number	Invalid Input
Email	Invalid Input
Please enter valid telephone numbers.

Note: If you have not advanced to the next page, check your application for error messages (marked in red) indicating missing information.

PART 2

Attachments A and B


Attachment A:	File must be under the size of 4MB and must be .pdfFile must be under the size of 4MB and must be .pdf	What's this?

	All Applicants MUST provide an Attachment A.
	Sole Proprietors:Attach a copy of proprietor's driver's license.
	General Partnerships:Attach a copy of the partnership's agreement.
	Corporations, LLCs, LLPs, and LPs: Attach a Certificate of Good Standing from
	the state where applicant was formed. The certificate must be dated within 6 months
	of the date the application is filed.

Attachment B:

File must be under the size of 4MB and must be .pdfFile must be under the size of 4MB and must be .pdf

What's this?

Error. On page 2 of the application form you indicated you propose using a trade name, but you have not uploaded Attachment B, proof of trade name registration.

	If applicant wishes to use a trade name, include proof of trade name registration
	from the jurisdiction where applicant's principal place of business is located.
	DC:Department of Licensing and Consumer Protection.
	MD:Department of Assessments and Taxation
	VA: Circuit Court in the county or city where applicant's principal place of business is located.

Note: If applicant's principal place of business is located outside the District of Columbia, Maryland, and Virginia, applicant may submit proof of trade name registration from either: 1) the jurisdiction where applicant's principal place of business is located; or 2) from the jurisdiction inside the Metropolitan District where applicant's local office or designated agent is located.

PART 3

Applicant's Verification

Applicant’s verification applies to all information submitted in support of this application, including supplemental filings made after this initial submission.

›› An application by a sole proprietor must be verified by the sole proprietor.

›› An application by a corporation, LLC or similar entity must be verified by an officer.

›› An application by a partnership must be verified by a general partner.

* I, verify under penalty of perjury, under the laws of the United States of America, that I am qualified to make this application and that all information submitted in support of this application is true and correct to the best of my knowledge and belief.

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* I further verify that:

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1. Applicant owns or leases, or has the means to acquire through ownership or lease, one or more motor vehicle(s) that meets the Commission’s safety requirements and is suitable for the transportation proposed in this application.

2. Applicant has, or has the means to acquire, a motor vehicle liability insurance policy that provides the minimum amount of coverage required by Commission Regulation No. 58-02.

3. Applicant has access to, is familiar with and will comply with the Compact, the Commission’s rules, regulations and orders, and Federal Motor Carrier Safety Regulations as they pertain to transportation of passengers for hire.

Name*

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Date*

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Title (not required for sole proprietors)*

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Amount Due $

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Note: If you have not advanced to the next page, check your application for error messages (marked in red) indicating missing information.

	Check one or more boxes to indicate the type(s) of vehicle(s) applicant plans to use
	to provide for-hire passenger transportation.
	For each type of vehicle checked, please provide a count of the vehicle(s) applicant
	plans to begin operations with.
	For each type of vehicle checked, indicate the maximum seating capacity, including
	the driver

Charter Invalid Input	Sightseeing Invalid Input	Private-Pay Ambulatory & or Wheelchair Invalid Input
Other Mileage or Hourly Invalid Input	Airport Shuttle Invalid Input	Medicaid Invalid Input
Government Contract Invalid Input	Private Contract Invalid Input

Washington Metropolitan Area Transit Commission

E-Filing

Application Form

	Check one box to indicate whether applicant has a control relationship with one or more existing
	WMATC carriers. If so, specify the WMATC carrier(s).

	Applicant is in a common control relationship with one or more carriers - List WMATC Invalid Input
	number(s) Invalid Input
	Applicant has no WMATC carrier control relationship Invalid Input

	Check one or more boxes to indicate whether applicant currently holds passenger carrier authority
	from a federal and/or state agency. If so, list applicant's assigned carrier number.

	Check one box to indicate whether any transportation regulatory agency has
	investigated applicant and/or found applicant unfit within the past five years.

	Check one or more boxes to indicate the type(s) of transportation service
	and rates applicant proposes to charge.