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M- 936a (11-17). OVERSIZE/OVERWEIGHT PREVIOUS. APPLICATION FOR SPECIAL PERMIT NO.: HAULING PERMIT. ''ALL LINES (EXCEPT DASHES) MUST BE COMPLETED" APPLICATION ID: TYPE PERMIT REQUESTED: Single Trip Single Trip & Return Annual Seasonal _____months Emergency Preliminary Superload Final Superload _____ of _____. PERMIT OFFICE_____ NAME_____. REGISTERED NAME (Responsible Motor Carrier). ACCOUNT STREET_____. MOTOR CARRIER/PERMIT SERVICE ADDRESS. FEIN/SSN_____ CITY-STATE-ZIP CODE_____. IF NO MOTOR CARRIER ACCT. NO. 1 = IMMEDIATE PAYMENT. 3 = MONTHLY BILLING. BILL CODE_____ 4 = GOVERNMENTAL CHECK/MO # CHECK/MO #. PERMIT FEE. <. GROSS WEIGHT_____ (lbs.) LEGAL WEIGHT = _____(lbs.) TOTAL LENGTH <. _____(ft.) _____ (in.). <. TOTAL WIDTH _____ (ft.) _____ (in.) =_____(ft.)_____ (in.). BODY WIDTH (63A/63B)__ <.

HOW TO COMPLETE GENERAL APPLICATION FORM M-936A Completing PA Permit Application Form M-936A Following are detailed instructions for completing a Permit Application (Form M-936A). All fields underscored with solid lines must be completed. All fields underscored with dashed lines should be completed where applicable if information is known

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  General, Applications, General application, 936a

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