PORT ACCESS FORM

This information will be used for your truck to gain access to the Ports. Please complete EACH SECTION.

First Name *

Last Name *

DL State *

DL # *

Phone *

Email *

Please provide your truck information. Please double check the information provided to avoid any delays. If this truck is already added to this terminal, please only put the truck number.

If the truck is already in the port, please put the truck number below.

Truck Number

If the truck is NOT registered in the port, please complete the information below.

Vin Number

Make

Model

Truck Year

Engine Year

Tare Weight

Does the driver have an Active TWIC Card? *

If yes, do they know their TWIC Pin? *

Emergency Contact *

Cab Card

CDL Photo

The driver will get an email from Port of VA withing 24-48 hours.