Membership Application Form

Company : *

Phone : *

President : *

Fax : *

Representative : *

E-Mail Address : *

Mailing Address : *

Payment Schedule (please select one) *

Annual

Semi-Annual

Quarterly

Monthly

Membership Type (please indicate one) *

Public Utilities Commission Regulated Carrier

Private Carrier

Allied Member

Signature : *

Date *

HTA USE ONLY : Annual Dues *

Property Carriers : Number of power units* over 10,000 lbs. GVWR *

Passenger Carriers : Number of vehicles (regardless of GVWR) *

PUC# *

Type *

Property

Passenger

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* Power Units refers to straight trucks and tractors. It does NOT apply to trailers.

Your membership application is pending Board of Directors' approval. Members are subject to expulsion if obligations are delinquent more than 90 days. In the case of resignation, any outstanding balance must be paid in full.

DUES STRUCTURE

PUC Regulated Property & Passenger Carriers

Minimum Annual Dues - $240.00
Property Carriers: $150.00 plus $50.00 per power unit over 10,000 lbs. GVWR
Passenger Carriers: $150.00 plus $50.00 per vehicle (regardless of GVWR)
Maximum Annual Dues - $3,000.00

Private Carriers

Minimum Annual Dues - $240.00
$150.00 plus $20.00 per power unit over 10,000 lbs. GVWR
Maximum Annual Dues - $1,200.00

Allied Members

$360.00 Annual Dues

You may also mail your completed application to:

Hawaii Transportation Association P.O. Box 30166 Honolulu, HI 96820

If you have any questions, please call (808) 833-6628.

Payment Options *

Credit card form attached - 2% surcharge to be applied

Mailing in payment

Note:

Captcha

Payment Schedule (please select one) *

Annual

Semi-Annual

Quarterly

Monthly

For Credit Card Payments

If you would like to pay via credit card, please copy and paste the following page link and complete as required: https://www.htahawaii.org/chgcdform/

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