Confirmation of Carrier Leased On Agreement

This document is a confirmation of an existing agreement between the Owner/Operator and Authorizing Company listed below.

This is a binding document and will be considered proof of lease agreement. It will be considered permission to use the authorizing company's authority in the establishment of an account for the benefit of the owner/operator. If the lease agreement is terminated, DAT must be notified in writing within 24 hours of contract termination.


* Required Field
Owner / Operator
First Name: *
Last Name: *
Email: *
Company Name: *
Street Address: *
City: *
State: *
Zip Code: *
Phone #: *
Fax #: *
Authorizing Company
Company Name: *
Company Rep First Name: *
Company Rep Last Name: *
Title: *
Email: *
MC #: *
Street Address: *
City: *
State: *
Zip Code: *
Phone #: *
Fax #: *
* Required Field

Contact Us

  • DAT Compliance Team
  • P.O. Box 23519
  • Portland, OR 97281-5081
  • Phone: 800-547-5417
  • Fax: 800-280-2475
  • customer.support@dat.com
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