State Form 49061 (M-233DR) "Annual Mobile Home Rig Dealer's Permit Application" - Indiana

What Is State Form 49061 (M-233DR)?

This is a legal form that was released by the Indiana Department of Revenue - a government authority operating within Indiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2011;
  • The latest edition provided by the Indiana Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of State Form 49061 (M-233DR) by clicking the link below or browse more documents and templates provided by the Indiana Department of Revenue.

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Download State Form 49061 (M-233DR) "Annual Mobile Home Rig Dealer's Permit Application" - Indiana

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FORM M-233DR
Indiana Department of Revenue
Starting Date:
January 1
Expiration Date: December 31
State Form 49061
Annual Mobile Home
(R5 / 7-11)
Fee:
$40.00
Rig Dealer's Permit Application
Name of Transporting Company:
FEIN:
Address:
SSN: (if sole proprietor)
City, State, and Zip:
Make of Tractor:
Tractor Year:
Daytime Telephone:
Fax Number:
License State:
Plate Number:
Vehicle Type:
Full Vehicle Identifi cation Number:
Dealer's License Number:
(As issued by the Bureau of Motor Vehicles)
Overall Length: Up to 85'
Overall Width: 8'6" up to 12'4" wide
Overall Height: Legal
Total Gross Weight: Legal
Type of Permit: over 8'6" up to 12'4" Mobile Home Rig Dealer
This TRACTOR MOBILE HOME RIG exceeds the legal size and weight limits and cannot be reduced by method of
disassembly. This permit provides for transportation via all State and Interstate Highways offi cially opened to traffi c
except I-65 and I-70 inside I-465.
No other routes, including detours, are authorized by this permit under any condition.
The General Provisions on the reverse side of this form and any Special Provisions are incorporated by reference into
this permit and are as fully binding upon the permittee as if they had appeared on the face of this permit. This permit is
void or invalid if the General Provisions and Special Provisions are omitted from the reverse side of this form or are not
attached. The Indiana Department of Revenue disclaims any responsibility in relation to the correctness in the transmit-
ting of the permit as a whole or any part thereof, including general or special provisions.
This permit is valid only for transporting commodities under the company name shown above, and if signed by both an
authorized company owner or offi cer, and driver. The driver's signature attests to the fact that the description of the ve-
hicle and load is accurate and that the General Provisions and any Special Provisions have been read and understood
by the driver. Under the penalty of perjury, I have examined this permit, and to the best of my knowledge and belief, it
is true, complete and correct. I also understand that all provisions of the Transporting Agreement apply in full force.
Driver's Signature(s):
Date(s):
____________________________________________
____________________________________________
____________________________________________
____________________________________________
__________________________________________
____________________________________________
Company Owner or Responsible Offi cer
Date
FORM M-233DR
Indiana Department of Revenue
Starting Date:
January 1
Expiration Date: December 31
State Form 49061
Annual Mobile Home
(R5 / 7-11)
Fee:
$40.00
Rig Dealer's Permit Application
Name of Transporting Company:
FEIN:
Address:
SSN: (if sole proprietor)
City, State, and Zip:
Make of Tractor:
Tractor Year:
Daytime Telephone:
Fax Number:
License State:
Plate Number:
Vehicle Type:
Full Vehicle Identifi cation Number:
Dealer's License Number:
(As issued by the Bureau of Motor Vehicles)
Overall Length: Up to 85'
Overall Width: 8'6" up to 12'4" wide
Overall Height: Legal
Total Gross Weight: Legal
Type of Permit: over 8'6" up to 12'4" Mobile Home Rig Dealer
This TRACTOR MOBILE HOME RIG exceeds the legal size and weight limits and cannot be reduced by method of
disassembly. This permit provides for transportation via all State and Interstate Highways offi cially opened to traffi c
except I-65 and I-70 inside I-465.
No other routes, including detours, are authorized by this permit under any condition.
The General Provisions on the reverse side of this form and any Special Provisions are incorporated by reference into
this permit and are as fully binding upon the permittee as if they had appeared on the face of this permit. This permit is
void or invalid if the General Provisions and Special Provisions are omitted from the reverse side of this form or are not
attached. The Indiana Department of Revenue disclaims any responsibility in relation to the correctness in the transmit-
ting of the permit as a whole or any part thereof, including general or special provisions.
This permit is valid only for transporting commodities under the company name shown above, and if signed by both an
authorized company owner or offi cer, and driver. The driver's signature attests to the fact that the description of the ve-
hicle and load is accurate and that the General Provisions and any Special Provisions have been read and understood
by the driver. Under the penalty of perjury, I have examined this permit, and to the best of my knowledge and belief, it
is true, complete and correct. I also understand that all provisions of the Transporting Agreement apply in full force.
Driver's Signature(s):
Date(s):
____________________________________________
____________________________________________
____________________________________________
____________________________________________
__________________________________________
____________________________________________
Company Owner or Responsible Offi cer
Date
Indiana Department of Revenue
General Provisions of the M-233DR
Annual Mobile Home Rig Dealer's Application
The permitted vehicle must be marked on the front and rear
The permitted vehicle and/or load will at no time block traffi c
with a sign reading "oversize load". The sign must be at least
from the use of the highway, nor will equipment, load, or object
18" high, at least 6' but not over 8' wide, and the letters must
be loaded or unloaded within the travelway, nor will vehicle
be black, 12" high, with a 2" stroke on yellow background.
or object be permitted to be parked either day or night on the
However, offi cially approved color combinations or wording
shoulder or right-of-way.
of other states will be permitted when the trip originates out-
side Indiana. The permitted vehicle must have its low beam
The permitted vehicle and load are not to be operated during
headlights on while transporting an oversize load.
the existence of hazardous weather, road, and traffi c condi-
tions, and/or when visibility is less than 500 feet. Oversize
The permitted vehicle and/or load must be marked with 6 red
loads will not be operated at any time when wind velocity
fl ags. One of these will be placed as near to each corner of
exceeds 25 miles per hour.
the vehicle and/or load as possible, and one will be placed on
each side at the widest point. These fl ags must be in good
This permit does not apply to any state roads or bridges that
condition, be plain red with no fi gures, be a minimum of 18"
are closed for construction purposes, or to any roads or bridg-
square, and be placed so that they can be seen clearly by
es that are posted for gross load limit and/or any structures,
approaching traffi c.
wires, etc., having a restricted height clearance that will not
clear said load; or to any county roads or city streets.
The operator of the permitted vehicle must be at least 18 years
of age and hold a valid commercial driver's license.
This permit is issued to the tractor designated on the reverse
side of this form. It may not be utilized in conjunction with
The driver of the permitted vehicle and/or load, or the person
any other tractor. The original permit must be maintained in
in direct charge of transporting such object, must have the
the permitted vehicle. A duplicate of the permit is not valid
permit in his possession during the transportation, and will
for purposes of any movement. Any violation of this permit
show the permit, on demand, to any police offi cer or authorized
will automatically cause the permit to be void, and upon viola-
employee of the State of Indiana.
tion, any police offi cer will have the authority to withdraw said
permit. Operation without a valid permit may result in the
The mover and/or owner of the vehicle and/or load will be
issuance of citations for violation of applicable statutes.
held responsible in the event that it is necessary to remove
any buildings, railings, or other structures from the highway
N
T
E
P
: The Department of Rev-
OTICE
O
NFORCEMENT
ERSONNEL
or in the event that any buildings, railings or other structures
enue requests that you notify us as soon as possible after
are damaged, said cost of the removal and/or damage shall
withdrawing this permit, and that you forward documentation
be borne by the applicant.
clarifying the disposition of the citation as soon as possible.
Please follow hours of operation and holiday restrictions found
on the general provision sheet Form M-204. Must be kept in
the truck during travel.
Flagmen, in compliance with the provisions of the Indiana
Manual on Uniform Traffi c Control Devices, will be provided
at all locations needing such traffi c control. Locations requir-
ing fl agmen include, but are not limited to, encroachment
into opposing traffi c lanes and stops or blockage of traffi c at
locations where stops are not normally required by existing
traffi c control devices.
The permitted vehicle whose dimensions exceed 8'6" wide,
13'6" high, and/or 80' long must not be operated at a speed
in excess of 45 miles per hour.
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