City / State / ZIP:
Operator Status (Please Choose One):
Date and time
Do you understand that Network 1 Management is the Co-Guarantor of the truck you will be leasing? Network 1 is responsible for all non-made truck payments and insurance payments. Network 1 is held accountable for the asset of the truck and its value and Network 1 will hold you accountable to run all 48 states, stay out at least 2 weeks minimum, be able and willing to drive 2,500 miles per week to make this a success!
How many employers have you had in the past 3 years?
Do you have any roadside violations over the past 3 years? (Please Choose One):
Are you opposed to force dispatch as long as you bring home at least $1000 per week? (Please Choose One):
What other violations will we find on your MVR (Multiple suspensions, child support issues, etc)?
Are you willing and ok with running in all 48 states? (Please Choose One):
How long do you prefer to stay out before any home time? (Please Choose One):
Month or more
Do you have any sort of savings incase something were to happen to your truck or business? (Please Choose One):
Do you have any felonies in the past 7 years? (Please Choose One):
By signing your name below, you agree and acknowledge all questions have been answered truthfully to best of your ability and you agree to all of Network 1's requirements.
Do you have at least 2 years OTR tractor trailer experience within the past 5 years that we will be able to verify? (Please Choose One):
Do you have any misdemeanors in the past 5 years? (Please Choose One):
After all deductions, how much do you expect to earn on your weekly settlement (take home)? This would be after all deductions were taken out (i.e. Truck Payment, Trailer Payment, Fuel, Insurance, and all other deduction on the previous question)?:
Have you had your Class A CDL for at least 2 years? (Please Choose One):
When you do have your home time, how long do you prefer to stay home on average? (Please Choose One):
4 Days or more
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Thank you for contacting us! If needed, you will hear back within 48-72 hours.
Do you have a Class A CDL? (Please Choose One):
Trailer Type (Please Choose One):
What moving violations will be on your MVR during the past 3 years?
How many miles can you or how many miles are you willing to run each week? (Please Choose One):
If Lease Purchase, have you ever leased a truck through Quality Companies? (Please Choose One):
Are you at least 23 years old? (Please Choose One):
Do you understand all of these deductions (Please Check if you agree):
Reefer Rental is $595 / week
Van Rental is $210 / week
Escrow Account is $1,500 and $100 / week will be deducted until reached
Drug Testing is $75 (one time fee)
Weekly Fuel Tax is $25 / week
Transflo is $7 / week
Occupational Accident is $42 / week if interested (Not required)
License Plate is $2,200 per year and $75 / week until reached.
Heavy Highway Use Tax (2290), is $550 each year but is pro-rated down each month
Do you have any accidents during the past 3 years, both commercial and personal vehicles? (Please Choose One):
Do you have more than 3 points on your MVR? (Please Choose One):
If you are a Lease Purchase applicant, can you pay for your travel to get to the location your truck will be at or will you need our financial help and to be deducted on your first settlement?
CARRIERS WITH AUTHORITY
New Operator Profile
Do you have your own EIN number? (Please Choose One):
Did your recruiter explain to you all the weekly deductions and do you understand them all? (Please Choose One):
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