Form HSMV85046 Schedule G "Estimated Miles and First Year Applicants" - Florida

What Is Form HSMV85046 Schedule G?

This is a legal form that was released by the Florida Department of Highway Safety and Motor Vehicles - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2011;
  • The latest edition provided by the Florida Department of Highway Safety and Motor Vehicles;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form HSMV85046 Schedule G by clicking the link below or browse more documents and templates provided by the Florida Department of Highway Safety and Motor Vehicles.

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Download Form HSMV85046 Schedule G "Estimated Miles and First Year Applicants" - Florida

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Department of Highway Safety and Motor Vehicles
Division of Motorist Services
Bureau of Commercial Vehicle and
Driver Services
ESTIMATED MILES AND FIRST YEAR APPLICANTS
SCHEDULE G
 
ACCOUNT NAME 
MAILING ADDRESS 
PHYSICAL ADDRESS 
ADDRESS 
ADDRESS
CITY, STATE, ZIP 
CITY, STATE, ZIP
TELEPHONE NUMBER 
FEDERAL EMPLOYER IDENTIFICATION NUMBER 
 
 
 
 
 Florida Straight Plate
1.   Describe how your vehicle(s) is/are currently 
 Apportioned Plate
registered, and provide a copy of the vehicle 
 Other
registration(s).                           (Check  One) 
2.  Have you previously been denied registration?
Yes  
No  
3.  In the past, have you had IRP registration in Florida?
Yes  
No  
      If yes, please indicate the name and account number on previous account(s):
 
 
4.  Has your registration ever been suspended or revoked?
Yes  
No  
5.  Do you hold any type of operating authority? 
Yes  
No  
      If yes, briefly describe:  
 
6.  Are your vehicle(s) presently leased to any individual/company?
Yes  
No  
      If yes, list the  name and address: 
 
7.  Have your vehicle(s) been previously registered under any other name?
Yes  
No  
      If yes, list each name and address: 
 
8.  Has any permitting service, remittance agency, trucking service agency, consultant, or other 
Yes  
No  
      individual assisted you in the preparation of your IRP application?
      If yes, list names and addresses: 
 
9.  How did you determine the jurisdictions you chose to apportion with?
 
 
 
10. Actual distance is required if you owned or leased any power unit during the reporting
Yes  
No  
       period identified on the mileage schedule.  Did you accrue actual miles under the IRP during 
       the reporting period? 
 
11. If you currently have apportioned vehicle plates, or if you had apportioned vehicle plates in the past, why are
       estimated miles being used:  (please explain‐‐attach additional pages, if necessary)
 
 
12. Have you ever reported estimated miles in the jurisdiction(s) in which you are requesting? 
Yes  
No  
 
I (We) hereby affirm that the information set forth herein is true and correct:
 
 
Authorized Signature                                            Title                                    Date
Authorized Signature                                            Title                                    Date
 
HSMV 85046  (6/11) 
Department of Highway Safety and Motor Vehicles
Division of Motorist Services
Bureau of Commercial Vehicle and
Driver Services
ESTIMATED MILES AND FIRST YEAR APPLICANTS
SCHEDULE G
 
ACCOUNT NAME 
MAILING ADDRESS 
PHYSICAL ADDRESS 
ADDRESS 
ADDRESS
CITY, STATE, ZIP 
CITY, STATE, ZIP
TELEPHONE NUMBER 
FEDERAL EMPLOYER IDENTIFICATION NUMBER 
 
 
 
 
 Florida Straight Plate
1.   Describe how your vehicle(s) is/are currently 
 Apportioned Plate
registered, and provide a copy of the vehicle 
 Other
registration(s).                           (Check  One) 
2.  Have you previously been denied registration?
Yes  
No  
3.  In the past, have you had IRP registration in Florida?
Yes  
No  
      If yes, please indicate the name and account number on previous account(s):
 
 
4.  Has your registration ever been suspended or revoked?
Yes  
No  
5.  Do you hold any type of operating authority? 
Yes  
No  
      If yes, briefly describe:  
 
6.  Are your vehicle(s) presently leased to any individual/company?
Yes  
No  
      If yes, list the  name and address: 
 
7.  Have your vehicle(s) been previously registered under any other name?
Yes  
No  
      If yes, list each name and address: 
 
8.  Has any permitting service, remittance agency, trucking service agency, consultant, or other 
Yes  
No  
      individual assisted you in the preparation of your IRP application?
      If yes, list names and addresses: 
 
9.  How did you determine the jurisdictions you chose to apportion with?
 
 
 
10. Actual distance is required if you owned or leased any power unit during the reporting
Yes  
No  
       period identified on the mileage schedule.  Did you accrue actual miles under the IRP during 
       the reporting period? 
 
11. If you currently have apportioned vehicle plates, or if you had apportioned vehicle plates in the past, why are
       estimated miles being used:  (please explain‐‐attach additional pages, if necessary)
 
 
12. Have you ever reported estimated miles in the jurisdiction(s) in which you are requesting? 
Yes  
No  
 
I (We) hereby affirm that the information set forth herein is true and correct:
 
 
Authorized Signature                                            Title                                    Date
Authorized Signature                                            Title                                    Date
 
HSMV 85046  (6/11)