Carrier Setup Form – AGS Trucking

Company Name

Name *

First

Last

Phone

Email *

Website / URL

Address

Address Line 1

Address Line 2

City

State

Zip Code

MC # / DOT #

Tax ID

Number of Tractors you Operate

Areas and Lanes you operate in

Upload Picture of Drivers license

Upload Certificate of Insurance

W-9 Form Completed

Quick Pay Selected

Net 21; No QuickPay Must have your own Trailer
Net 2: 2% Quick Pay Requires $2,000 Escrow (Eligable when you work exclusively with us)

Select how quickly you prefer to be paid from our company

Bank ACH Inormation: Bank Name

ACH Routing Number

ACH Account Number

By Signing bellow I agree to the payments terms and to the accuracy of the information included: *

Sign Your Name