All permit fees are per vehicle. This section will be auto-populated by information entered on page 2.

The Annual Ready-Mixed Concrete Truck Permit may only be used by a truck operating on three-axles. Steering axle weight cannot exceed 650 PSI x Tire Tread Width x No. of Tires (ex: 650 X 10:00 X 2 = 13,000 lbs.) Any single axle, regardless of tire size, may not exceed 25,300 lbs. Two-axle groups may not exceed 50,600 lbs.

The Texas Department of Motor Vehicles maintains the information collected through this form. With few exceptions, you are entitled upon request to be informed about the information that we collect about you. Under Sections 552.02, 552.023 and 559.004 of the Texas Government Code, you are entitled to receive and review the information, and to have us correct erroneous information.

Annual Ready-Mixed Concrete Truck Permit P. O. Box 13529 - Annual Ready-Mixed Concrete Permit

Austin, Texas 78711-3529 Phone: 800/299-1700

$ =X$ $1,000Annual Ready-Mixed Concrete Permit FeeTOTAL FEE AMOUNTTOTAL VEHICLESFEE

All permit fees are non-refundable.

Form 1755 (Rev. 05/21) Page 1 of 3

Section 1 - Customer InformationCompany Name Customer Account Number

Mailing Address City State Zip

Daytime Phone Number Fax Number/Email Address

Contact Person Permit Start Date

Section 2 - Permit Conditions

I attest that the vehicle(s) listed in this application will not operate on more than three axles when operating under the provisions of the permit.

Section 3 - Permit Fees

Section 4 - Payment

For faster processing apply online via the Texas Permitting and Routing Optimization System (TxPROS) at TxPROS.TxDMV.gov.

Check, Cashier's Check or Money Order (Make payable to the Texas Department of Motor Vehicles)

To pay by credit card or ACH apply online via TxPROS.

Year/Make Complete VIN Current License Plate Number State

1.

23.

21.

14.

12. 11. 10. 9. 8. 7. 6.

5. 4. 3.

2.

15.

19.

25.

24.

22.

20.

18. 17. 16.

13.

Vehicle must be registered for the maximum gross weight for the vehicle. A Ready-Mixed Concrete Truck Permit does not authorize the vehicle(s) to exceed the manufacturer's tire load rating FMCSR 393.75f.

Total number of vehicles:

Unit Number

Annual Ready-Mixed Concrete Truck Permit

Vehicle Report

Form 1755 (Rev. 05/21) Page 2 of 3

Section 5 - Vehicle Report

Mark an (X) for each selection (county name and number) in which permitted vehicle(s) will be operated. Make your selection(s) carefully as they cannot be changed once the permit has been issued.

Note: A separate application must be submitted for vehicles with different county selections.

Total Number of Counties Selected

Anderson Andrews Angelina Aransas Archer Armstrong Atascosa Austin Bailey Bandera Bastrop Baylor Bee Bell Bexar Blanco Borden Bosque Bowie Brazoria Brazos Brewster Briscoe Brooks Brown Burleson Burnet Caldwell Calhoun Callahan Cameron Camp Carson Cass Castro Chambers Cherokee Childress Clay Cochran Coke Coleman Collin Collingsworth Colorado Comal Comanche Concho Cooke Coryell

All Counties in Texas Cottle Crane Crockett Crosby Culberson Dallam Dallas Dawson Deaf Smith Delta Denton DeWitt Dickens Dimmit Donley Duval Eastland Ector Edwards Ellis El Paso Erath Falls Fannin Fayette Fisher Floyd Foard FortBend Franklin Freestone Frio Gaines Galveston Garza Gillespie Glasscock Goliad Gonzales Gray Grayson Gregg Grimes Guadalupe Hale Hall Hamilton Hansford Hardeman Hardin Harris Harrison

Hartley Haskell Hays Hemphill Henderson Hidalgo Hill Hockley Hood Hopkins Houston Howard Hudspeth Hunt Hutchinson Irion Jack Jackson Jasper Jeff Davis Jefferson Jim Hogg Jim Wells Johnson Jones Karnes Kaufman Kendall Kenedy Kent Kerr Kimble King Kinney Kleberg Knox Lamar Lamb Lampasas LaSalle Lavaca Lee Leon Liberty Limestone Lipscomb Live Oak Llano Loving Lubbock Lynn Madison

Marion Martin Mason Matagorda Maverick McCulloch McLennan McMullen Medina Menard Midland Milam Mills Mitchell Montague Montgomery Moore Morris Motley Nacogdoches Navarro Newton Nolan Nueces Ochiltree Oldham Orange Palo Pinto Panola Parker Parmer Pecos Polk Potter Presidio Rains Randall Reagan Real Red River Reeves Refugio Roberts Robertson Rockwall Runnels Rusk Sabine San Augustine San Jacinto San Patricio San Saba

Schleicher Scurry Shackelford Shelby Sherman Smith Somervell Starr Stephens Sterling Stonewall Sutton Swisher Tarrant Taylor Terrell Terry Throckmorton Titus Tom Green Travis Trinity Tyler Upshur Upton Uvalde Val Verde Van Zandt Victoria Walker Waller Ward Washington Webb Wharton Wheeler Wichita Wilbarger Willacy Williamson Wilson Winkler Wise Wood Yoakum Young Zapata Zavala

Annual Ready-Mixed Concrete Truck Permit

County Designation Report

For more information about Annual Ready-Mixed Concrete Truck Permits, visit our website at www.TxDMV.gov. For comments concerning the application process contact (800) 299-1700 or email MCD_SizeWeight@TxDMV.gov.

Page 3 of 3Form 1755 (Rev. 05/21)

Section 6 - County Designation Report