<p> ASSOCIATION MEMBERSHIP REGISTRATION</p><p>In making application for membership with the NorthAmerican Transportation Association Inc. (NTA Inc.) and for the procurement of any of the association’s programs, I or we are desirous of becoming a member of NTA Inc. and understand that the membership of NTA Inc. is limited to and made up entirely of separate transportation related companies consisting of at least one owner. I or We agree not to engage in any organized manner that would jeopardize our current business status thus resulting in the immediate rejection and denial of all benefits and services provided by NTA Inc. and it’s service providers. I or We hereby subscribe to the goals of the association by promoting a drug-free environment and encouraging the maintenance and operation of commercial motor vehicles in a manner that safeguards and protects the health and safety of the general public.</p><p>If accepted for membership, I or We agree to comply with and follow all regulations as mandated by the applicable state and federal regulations and, if we fail or refuse to comply with such regulations, or engage in any manner that will endanger either the membership of or NTA Inc. itself, I or We will cease and desist such actions and will indemnify and hold harmless NTA Inc., it’s officers, agents, service providers and independent contractors providing services to the Company from and against any liability, cost or expense resulting from such failure or refusal. We understand that we may renew our enrollment for successive renewal terms of one (1) year upon payment of NTA’s then prevailing renewal fee.</p><p>We agree to forward all fees due for services procured under this membership within ten (10) days. THIS FORM MUST BE SIGNED by an authorized representative of your company and returned with $60.00 to NTA Inc. before any services or benefits can be started. Please keep a copy of this form for your record keeping as proof of your association membership with NTA Inc. Please return this application to the NorthAmerican Transportation Association Inc., 2533 N Carson St, Suite 346, Carson City, NV 89706. [www.ntassoc.com]</p><p>PLEASE PRINT Date ______NTA ID # ______</p><p>Name of Company/Individual ______</p><p>Mailing Address ______</p><p>Physical Address ______</p><p>City/State ______Zipcode ______</p><p>US DOT# ______FMCSA MC # ______STATE AUTHORITY # ______</p><p>Phone: ( ) ______FAX: ( ) ______</p><p>Email address ______Web site ______</p><p>Total number of employees you will enroll ______FOR OFFICE USE ONLY </p><p>Total number of Independent Contractors you have to enroll ______DATE:______ CHECK # ______ CASH ______</p><p>______AMT REC'D ______RE: ______Authorized Signature</p><p>______Print Name</p><p>SEE REVERSE SIDE FOR LIST OF SERVICES AND PRODUCTS</p><p>CHECK OFF OTHER SERVICES THAT YOU ARE INTERESTED IN We will have one of our authorized service providers get in touch with you directly</p><p>Services found on the NTA Website are marked - W Service by Authorized Service Provider - S A L Air Brake Systems Seminars S Lawyer – Former US DOT available S Anti-Terrorism Security HazMat Plan W Licensing – Truck and Trailer S B M Background Checks – Civil and Criminal W Motor Carrier Contract Package W Biennial Inspection of Terminal Guide W Motor Carrier Log Auditing Policy W Brokers Book – Nationwide List of Brokers W</p><p>C Comparison of Tax Aspects of Business Entities W CA CHP Carrier Safety Compliance Handbook W N Credit Union W NTA Business Management Guide W CSA 2010 Scorecard W O D Occupational Accident Programs – Nationwide W Drug & Alcohol Program – Accredited Program W Out-of-Service Criteria - North American Uniform W Driver Qualification Files W S Daily Vehicle Inspection Seminars – 2 hours S Safety Consulting W Driver Behind-the Wheel Evaluations – Limited S Security Plan for Hwy Trnsprt of HazMat – 54 pgs W Driver Daily Vehicle Inspection Forms S</p><p>E Electronically File 2290 Tax Forms S T Tax and Bookkeeping S F Truck Driving School – Nationally Accredited S FMCSA Motor Carrier Authority S Truck Cargo Insurance S FMCSA Pre-Screening Service W Truck Liability Insurance S Federal Leasing Regulations W Forklift Training S U US DOT Official Internet Training W H US DOT Audits W S Health Benefits (Group) – Nationwide PPO W US DOT Safety Compliance Review W S Hazardous Materials Security Plan W Hazardous Materials Training W S Hazardous Materials Consulting - CDMS S I V IFTA – Mileage & Fuel Tax Reporting S Vehicle Maintenance Files W IRS Trucking Audit Manual W Vision Plan – Nationwide W Independent Contractor Contract Package W W Driver Qualification Files W Web Page Design & Hosting for Members S Invoice Factoring W Identity Theft Program W Independent Contractor vs Employee Dilemma W</p><p>Be sure to order Our # 1 Book " Become a Successful Truck Owner Operator " $15.50 includes tax, shipping/handling Our # 2 Book " The Road to Financial Success " A money management Tool for Owner Operators $21.25, tax, S/H Our # 3 Book “ The Business Management Guide” A business management tool for Owner Operators $21.60, tax, SH</p>