New York Highway Use Tax form – New York Highway Use Tax

Application

Your USDOT*

Email Address*

Business Phone Number*

Year of Registration?

2025

Records Keeping Location & Keeper

Full Name *

New

Same as Physical Address

Same as Mailing Address

Street

City

State

Zip Code

Please provide your EIN or SSN *

EIN

SSN

Legal Name *

Doing business as (DBA) name *

Physical Address

Same as Physical Address

Mailing Address

Choose one option below

A bill(assessment)

A five-digit PIN

Assessment ID number

Five-digit PIN:

Each Principal Officer of a Corporation or Partner (THIS COULD HAVE ONE OR MULTIPLE PEOPLE LISTED)

Full Name *

Position*

SSN*

Street

City

State

Zip Code

Vehicle Details

VIN*

License Plate*

Issued State*

Unit#*

Vehicle Year*

Make*

Model*

Type of fuel used*

GVW*

Unloaded Weight*

Truck status*

Number of axels*

No.	Make & Model	Licence Plate#	GVW	Action
START ADDING VEHICLE
Total Cost: $0.00

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Payment Information

Order Details

Vehicle Total	:
Total Cost	:	$

Billing Address

New

Same as Physical Address

Same as Mailing Address

Street

City

State*

Zipcode

I certify that I am the authorized holder and signer of the credit card referenced above. I certify that all the information above is complete and accurate.

I understand that the information input is correct to my knowledge. Submitting false information could result in penalties and fines. It is a federal crime to submit false information in an attempt to commit fraud.

I hereby authorize the collection of payment to DOT Operating Authority Inc., (DBA) New York Highway Use Tax, for all charges as indicated above. I acknowledge that charges to my provided payment method may not exceed the total amount listed under the “TOTAL COST” field. I understand that I am responsible for the full amount listed in the “TOTAL COST” field. I understand that this authorization is only in effect during the time period of this transaction. If any additional charges are to need authorization, a new authorization form will have to be completed.

I acknowledge that the total amount of today’s transaction, indicated under the “TOTAL COST” field includes any and all Federal, State, and Local Government fees.

I hereby acknowledge and agree that after the charges are authorized, a DOT Operating Authority Inc., (DBA) New York Highway Use Tax agent will be assigned within 15 minutes to complete the order. Once the agent has been assigned, the payment cannot be cancelled, and the charges are non-refundable. DOT Operating Authority Inc., (DBA) New York Highway Use Tax does not accept any responsibility for refusal or reversal of payments, which shall be a matter between you and your credit card issuer.

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Name of person signing

Date signed

04/25/2025

Signature

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New York Highway Use Tax (HUT)Form