Estimated Miles And First Year Applicants Schedule G)
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Estimated Miles And First Year Applicants Schedule G) Form. This is a Indiana form and can be use in Department Of Revenue Statewide.
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Tags: Estimated Miles And First Year Applicants Schedule G), INIRP-G, Indiana Statewide, Department Of Revenue
State of Indiana
Form INIRP-G
International Registration Plan
State Form 48125
(R2 / 2-11)
SCHEDULE G
Legal Name:
FEIN/SSN:
IRP Account:
Fleet:
Staggered Month:
1. Have you ever registered this vehicle or any other vehicles in Indiana?
Yes
□
No
□
2. If yes please attach a copy of the previous registration(s), list under what name they were registered and the last date of
registration: ______________________________________________________________________________________
3. If you have not been IRP registered in Indiana, have you been IRP registered in any other state?
Yes
□
No
□
(Please attach previous registrations)
If you are estimating mileage for a first time or for expanded operations you must complete this form to justify your estimates. In accordance with the IRP agreement, your estimates will not be used if they do not appear to be reasonable.
An estimated mileage chart is available for your use if you do not have an exact plan of operation of travel per state. The estimated
mileage chart is determined by actual operations of other carriers registered in Indiana.
Example of how to complete your trips below if you plan to use your own plan of operation:
State:
Kentucky
List routes of travel:
State:
Mileage:
X
No. of Trips:
X
Vehicles:
=
Total Estimated Mileage
245
X
3
X
2
=
1,470
No. of Trips:
X
Vehicles:
=
Total Estimated Mileage
Louisville, KY to Clarksville, IN
Mileage:
X
X
X
=
List routes of travel:
State:
Mileage:
X
No. of Trips:
X
X
Vehicles:
X
=
Total Estimated Mileage
=
List routes of travel:
State:
Mileage:
X
No. of Trips:
X
X
Vehicles:
X
=
Total Estimated Mileage
=
List routes of travel:
State:
Mileage:
X
No. of Trips:
X
X
Vehicles:
X
=
Total Estimated Mileage
=
List routes of travel:
State:
Mileage:
X
No. of Trips:
X
X
Vehicles:
X
=
Total Estimated Mileage
=
List routes of travel:
State:
Mileage:
X
No. of Trips:
X
X
X
Vehicles:
=
Total Estimated Mileage
=
List routes of travel:
Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the
best of my knowledge and belief, it is true, correct, and complete.
________________________________________________________
Signature of Applicant
____________________________
Date
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