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Penalty provisions subject to the laws of the registration state. Date Name Of Owner Or Authorized Representative Printed Signature Title Instruction Sheet for UCR Carrier Registration What is my base state for UCR A If your principal place of business as completed in Section 1 of the form is AK AL AR CA CO CT DE GA IA ID IL IN KS KY LA MA ME MI MN MO MS MT NC ND NE NH NM NY OH OK PA RI SC SD TN TX UT VA WA WI or WV you must use that state as your base state. Form UCR-1 may be obtained from...
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