Form MCS-82 "Motor Carrier Public Liability Surety Bond Under Sections 29 and 30 of the Motor Carrier Act of 1980"

What Is Form MCS-82?

This is a legal form that was released by the U.S. Department of Transportation - Federal Motor Carrier Safety Administration on May 28, 2021 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 28, 2021;
  • The latest available edition released by the U.S. Department of Transportation - Federal Motor Carrier Safety Administration;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form MCS-82 by clicking the link below or browse more documents and templates provided by the U.S. Department of Transportation - Federal Motor Carrier Safety Administration.

ADVERTISEMENT
ADVERTISEMENT

Download Form MCS-82 "Motor Carrier Public Liability Surety Bond Under Sections 29 and 30 of the Motor Carrier Act of 1980"

Download PDF

Fill PDF online

Rate (4.6 / 5) 21 votes
FORM MCS-82
OMB No.: 2126-0008 Expiration: 05/31/2024
USDOT Number:
Date Received:
Please note, the expiration date as stated on this form relates to the process for renewing the Information Collection Request for this
form with the Office of Management and Budget. This requirement to collect information as requested on this form does not expire.
For questions, please contact the Office of Registration and Safety Information, Registration, Licensing, and Insurance Division.
A Federal Agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply
with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current
valid OMB Control Number. The OMB Control Number for this information collection is 2126-0008. Public reporting for this collection of information
is estimated to be approximately 2 minutes per response, including the time for reviewing instructions, gathering the data needed, and completing and
reviewing the collection of information. All responses to this collection of information are mandatory. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal
Motor Carrier Safety Administration, MC-RRA, Washington, D.C. 20590.
United States Department of Transportation
Federal Motor Carrier Safety Administration
Motor Carrier Public Liability Surety Bond
under Sections 29 and 30 of the Motor Carrier Act of 1980
FORM MCS-82
PARTIES
SURETY COMPANY
MOTOR CARRIER
COMPANY NAME
COMPANY NAME
STREET ADDRESS
CITY
STREET ADDRESS
CITY
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
Michigan
Micronesia
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland and Labrador
North Carolina
North Dakota
Northern Marianas
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
Michigan
Micronesia
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland and Labrador
North Carolina
North Dakota
Northern Marianas
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon
STATE
ZIP CODE
TELEPHONE NUMBER
STATE
ZIP CODE
TELEPHONE NUMBER
(type or print Principal Officer’s name and title)
(type or print Principal Officer’s name and title)
PURPOSE
This is an agreement between the Surety and the Principal under which the Surety, its successors and assignees, agree to be responsible
for the payment of any final judgment or judgments against the Principal for public liability, property damage, and environmental
restoration liability claims in the sums prescribed herein; subject to the governing provisions and the following conditions.
GOVERNING PROVISIONS
1. Sections 29 and 30 of the Motor Carrier Act of 1980
(49 U.S.C.
13906).
2. Rules and regulations of the Federal Motor Carrier Safety Administration (FMCSA).
FORM MCS-82 Page 1 of 3
Rev 5/28/2021
FORM MCS-82
OMB No.: 2126-0008 Expiration: 05/31/2024
USDOT Number:
Date Received:
Please note, the expiration date as stated on this form relates to the process for renewing the Information Collection Request for this
form with the Office of Management and Budget. This requirement to collect information as requested on this form does not expire.
For questions, please contact the Office of Registration and Safety Information, Registration, Licensing, and Insurance Division.
A Federal Agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply
with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current
valid OMB Control Number. The OMB Control Number for this information collection is 2126-0008. Public reporting for this collection of information
is estimated to be approximately 2 minutes per response, including the time for reviewing instructions, gathering the data needed, and completing and
reviewing the collection of information. All responses to this collection of information are mandatory. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal
Motor Carrier Safety Administration, MC-RRA, Washington, D.C. 20590.
United States Department of Transportation
Federal Motor Carrier Safety Administration
Motor Carrier Public Liability Surety Bond
under Sections 29 and 30 of the Motor Carrier Act of 1980
FORM MCS-82
PARTIES
SURETY COMPANY
MOTOR CARRIER
COMPANY NAME
COMPANY NAME
STREET ADDRESS
CITY
STREET ADDRESS
CITY
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
Michigan
Micronesia
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland and Labrador
North Carolina
North Dakota
Northern Marianas
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
Michigan
Micronesia
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland and Labrador
North Carolina
North Dakota
Northern Marianas
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon
STATE
ZIP CODE
TELEPHONE NUMBER
STATE
ZIP CODE
TELEPHONE NUMBER
(type or print Principal Officer’s name and title)
(type or print Principal Officer’s name and title)
PURPOSE
This is an agreement between the Surety and the Principal under which the Surety, its successors and assignees, agree to be responsible
for the payment of any final judgment or judgments against the Principal for public liability, property damage, and environmental
restoration liability claims in the sums prescribed herein; subject to the governing provisions and the following conditions.
GOVERNING PROVISIONS
1. Sections 29 and 30 of the Motor Carrier Act of 1980
(49 U.S.C.
13906).
2. Rules and regulations of the Federal Motor Carrier Safety Administration (FMCSA).
FORM MCS-82 Page 1 of 3
Rev 5/28/2021
FORM MCS-82
OMB No.: 2126-0008 Expiration: 05/31/2024
CONDITIONS
The Principal is or intends to become a motor carrier of property subject to the applicable governing provisions relating to financial
responsibility for the protection of the public.
This bond assures compliance by the Principal with the applicable governing provisions, and shall insure to the benefit of any person or
persons who shall recover a final judgment or judgments against the Principal for public liability, property damage, or environmental
restoration liability claims (excluding injury to or death of the Principal’s employees while engaged in the course of their employment,
and loss of or damage to property of the principal, and the cargo transported by the Principal). If every final judgment shall be paid for
such claims resulting from the negligent operation, maintenance, or use of motor vehicles in transportation subject to the applicable
governing provisions, then this obligation shall be void, otherwise it will remain in full effect.
Within the limits described herein, the Surety extends to such losses regardless of whether such motor vehicles are specifically described
herein and whether occurring on the route or in the territory authorized to be served by the Principal or elsewhere.
The liability of the Surety on each motor vehicle subject to the financial responsibility requirements of Sections 29 and 30 of the Motor
Carrier Act of 1980 for each accident shall not exceed $
, and shall be a continuing one notwithstanding any
recovery hereunder.
The surety agrees, upon telephone request by an authorized representative of the FMCSA, to verify that the surety bond is in force as of a
particular date. The telephone number to call is
.
This bond is effective from
(12:01 a.m., standard time, at the address of the Principal as stated herein) and
shall continue in force until terminated as described herein. The principal or the Surety may at any time terminate this bond by giving
(1) thirty–five (35) days notice in writing to the other party (said 35 day notice to commence from the date the notice is mailed, proof
of mailing shall be sufficient proof of notice), and (2) if the Principal is subject to the FMCSA’s registration requirements, by providing
thirty (30) days notice to the FMCSA (said 30 days notice to commence from the date notice is received by the FMCSA at its office in
Washington, D.C.). The Surety shall not be liable for the payment of any judgment or judgments against the Principal for public liability,
property damage, or environmental restoration claims resulting from accidents which occur after the termination of this bond as
described herein, but such termination shall not affect the liability of the Surety for the payment of any such judgment or judgments
resulting from accidents which occur during the time the bond is in effect.
SURETY
DATE
(affix Motor Carrier
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Micronesia
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Marianas
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
corporate seal)
CITY
STATE
(Principal Officer’s signature)
FORM MCS-82 Page 2 of 3
FORM MCS-82
OMB No.: 2126-0008 Expiration: 05/31/2024
ACKNOWLEDGMENT OF SURETY
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Micronesia
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Marianas
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
COUNTY OF
STATE OF
On this
day of
,
, before me personally came
, who,
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
13th
14th
15th
16th
17th
18th
19th
20th
21st
22nd
23rd
24th
25th
26th
27th
28th
29th
30th
31st
January
February
March
April
May
June
July
August
September
October
November
December
2017
2018
2019
2020
being by me duly sworn, did depose and say the he resides in
; that he/she is
of the
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Micronesia
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Marianas
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
, the corporation described in and which executed the foregoing instrument; that he knows
the seal of said corporation; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the board of
directors of said corporation; that he/she signed his/her name thereto by like order, and he/she duly acknowledged to me that he/she
executed the same for and on behalf of the said corporation.
(type or print Surety Officer’s name and title)
(affix Surety
corporate seal)
(Surety Officer’s signature)
(Surety Company File Number)
Filings must be transmitted online via the Internet at http://www.fmcsa.dot.gov/urs.
FORM MCS-82 Page 3 of 3
Page of 3