Clearing House Registration Form

USDOT Number -

Clearing House Registration Form

All employers and owner-operators covered by the Federal Motor Carrier Safety Administration (FMCSA) drug & alcohol testing program, who employ a CDL driver or themselves operate a commercial motor vehicles (CMV) on public roads are required by law to register with the FMCSA Drug and Alcohol Clearinghouse (DACH). The Clearinghouse is a secure online database that gives employers, the FMCSA, State Driver Licensing Agencies (SDLAs), and State law enforcement personnel real-time information about commercial driver’s license (CDL) and commercial learner’s permit (CLP) holders’ drug and alcohol program violations. Single owner-operators are required to select a consortia/third party administrator (C/TPA) in Clearinghouse, and all employers including single owner-operators are required to report violations, report return to duty tests, and run queries on prospective drivers as well as existing drivers who hold a CDL/CLP.

Billing Address

First Name

Last Name

Company Name

Address Line# 1

Address Line# 2

Country

State/Province

City

Zip / Postal Code

Phone Number

Alternate Phone Number

Enrollment Summary

Select Payment Method

Test Gateway

Billing Email *

First Name *

Last Name

Address

City

Country

State / Province

ZIP / Postcode

Phone

Company

Item

Price

Qty

Subtotal

Clearing House Registration Form

Qty 1

$199.00 Subtotal: $199.00

$199.00

Subtotal

$0.00

Fee

$0.00

Discount

$0.00

Total

$0.00