Skip to content
Home
Get Started
shippers
carriers
Request a Quote
Contact us
Register
Login
Menu
Home
Get Started
shippers
carriers
Request a Quote
Contact us
Register
Login
Join our Carriers team
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
-
Step
1
of 12
Name
*
First
Last
Email
*
Email
Do you currently contract with Aksarben?
*
Yes
No
Do you meet the below requirements to contract with Aksarben?
Yes
No
I have been in business as a carrier for at least 3 months I have a cargo insurance with coverage of at least $100,000 I have an auto insurance with coverage of at least $1,000,000
What best describes you?
*
Owner Operator
Owner
Dispatcher
Driver
"Annual" Earning
*
Next
Company Name
*
DBA
Business Address
*
Country
*
United States
Canada
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Province
*
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Zip Code
*
Postal Code
*
Next
Number of Drivers
*
Email
*
Email
Confirm Email
Phone#
*
Number of Trucks
*
Social Security (9 digits)
*
Next
Dispatch Contact
*
Phone#
*
Email
*
Fax
Next
MC#
*
DOT#
*
Driver Name
*
Phone#
*
Driver Email
*
Driving License#
*
ELD Provider
*
Next
Accounting Contact
*
Phone
*
After hours number
*
Email
*
Next
How would you like to get paid ?
*
Factoring
Quickpay
Standard Pay
Bank Name
*
Account#
*
Routing#
*
Bank Name
*
Account#
*
Routing#
*
Factoring Company
*
Mailing Address
*
Country
*
United States
Canada
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Province
*
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Zip Code
*
Postal Code
*
Next
Insurance Phone
*
Insurance Agent Name
*
Are you Smart Way certified?
*
Yes
No
Do you have EDI capability?
*
Yes
No
Do you have HAZ MAT Certification?
*
Yes
No
Next
MC Authority Certificate (Only upload requested type of document)
*
Click or drag a file to this area to upload.
Notice Of Assignment (Required If have a factoring company)
Click or drag a file to this area to upload.
Next
Bank you have
W9 Form (Only upload requested type of document)
*
Click or drag a file to this area to upload.
Next
Driver's License (Front Side)
*
Click or drag a file to this area to upload.
Driver's License (Back Side)
*
Click or drag a file to this area to upload.
Next
Certificate of Insurance (Only upload requested type of document)
*
Click or drag a file to this area to upload.
Submit