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Jobs at 123JobsForMe.com
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New Venture Questionnaire

New Venture Questionnaire

NEW VENTURE QUESTIONNAIRE
Named Insured*

The named insured is the business owner or legal entity
Effective Date of New Venture*

The date this New Venture started
FEIN# or Social Security #*

We must have either your Federal Employer Identification number or your Social Security Number
How long have you been driving tractor/trailer Units?*
What date did you first receive your Drilver License and in What State?*
Who did you drive for prior to becomming a new Venture?*
What did you haul prior to becoming a new venture?*
Provide your prior route*
What will your "future route" be?*
2000
What will you be hauling and for whom?*
Will the New Venture require financing of the operation?*
- Yes
- No
With whom will the new financing be?*
Are you applying for an ICC Authority with the Named Insured Above?*
- Yes
- No
When?*
Since you answered no, Who's authority will you use?
Do you expect to increase the number of vehicles within one year?*
- Yes
- No
How many and when?
HIRING PRACTICES AND VEHICLE MAINTENANCE
Describe you hiring practices
Describe your vehcile maintenance program*
Will you allow trip leasing?*
- Yes
- No
Will you allow team drivers?
- Yes
- No
Are family members traveling with you?*
- Yes
- No
Name relationship and name of family members who travel with you
What are your anticipated gross yearly receipts?*
What is your total yearly estimated annual mileage?*

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+(001) 123 123 1234
4964 Adamsville Road, TX, 78550
email@yoursite.com

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