4. Are you a business entity registered with the PA Department of State? YES tf NO, you must register (see checklist on how to register)

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1 Secretary \ fepmi OF > Revised 12/1/13 Pennsylvania Public Utility Coission rrruuir 5 *! 400 North Street, Second Floor TbCHNIL At Harrisburg, PA (717) ro Application for Motor Coon Carrier or Motor Contract Carrier of <ZZJ Household Goods in Use. 5 Z. 2 THIS APPLICATION IS REQUIRED TO REQUEST A CERTIFICATgOF _ PUBLIC CONVENIENCE (FOR COMMON CARRIERS) OR PERMIT ffip'r 0 1 ' CONTRACT CARRIERS) TO OPERATE AS A COMMERCIAL CARglER OF HOUSEHOLD GOODS IN USE. 1. Legal Nae of Applicant (Individual, Partnership or Corporation) ^ HINPMAN & ISAACS MOVING & STORAGE INC. If you are an individual who has not fored any type of corporate entity, you should enter your nae as it will appear on your insurance docuents. If you are filing for a partnership, but not a liited liability partnership, the naes of all partners ust be entered on this line. Those naes should be entered as they will appear on your insurance docuents. This includes husbands and wives filing jointly. If you are filing for a corporate entity (corporation, liited liability copany, or liited liability partnership), even if you are the sole shareholder eber, you ust enter the nae exactly as it appears on the registration papers fro the Corporation Bureau of the Pennsvlvania Departent of State. 2. Trade Nae (Attach a copy of fictitious nae registration if applicable) CD fr This is any nae which you will be operating under which differs fro the LEGAL NAME OF APPLICANT. A TRADE NAME is considered a FICTITIOUS NAME if the identity of the applicant cannot be readily deterined. EXAMPLE: John Doe is the applicant and wants to use the nae "Johnboy Trucking" as his trade nae. People cannot readily deterine that John Doe is the actual operator; therefore, the nae is fictitious and ust be registered as such. Trade naes such as "John Doe Trucking" or U J. Doe Trucking" are not considered fictitious and would not have to be registered. 3. Do you currently hold PUC Authority? NO Previous Authority? NO If YES, at PUC No. A- 4. Are you a business entity registered with the PA Departent of State? YES tf NO, you ust register (see checklist on how to register) If YES, provide your PA Corporation Bureau Entity ID Nuber (see checklist and indicate type of business entity registered)

2 5. Physical Address (do not use PO Box) 122 HINDMAN LANE Street Address BUTLER, PA City, State and Zip Code (724) BUTLER Telephone Nuber County The address entered here should reflect the actual location of the business. This is the address the Coission needs in order to dispatch Enforceent Officers to inspect equipent. 6. Mailing Address (if different fro Physical Address) 1887 SANDY LAKE-G.C. ROAD Street Address JACKSON CENTER, PA City, State and Zip Code This is the address to which the Coission will send all official docuents issued by the Coission. If left blank, it will be assued that the MAILING ADDRESS is the sae as the PHYSICAL ADDRESS 7. Attorney (if applicable) Attorney's Nae & Telephone Nuber for this Filing Attorney's Address An attorney's nae should only be entered if an attorney is filing the application for a client and the application is being sent under the attorney's cover letter. 8. Does applicant hold interstate operating authority? No X Yes, at No. MC # Describe the service area proposed by this application. (Use the space below or attach additional sheet if space provided is not sufficient). To transport as a Coon Carrier, Household Goods in use Between Points in Butler County Exaples: ' 7b transport as a coon carrier, household goods in use between points in Mercer County. o To transport as a contract earner for the XYZ Copany, household goods in use, fro points in Elk County to points in PA.

3 10. Certification: Applicant certifies that it is not now engaged in unauthorized intrastate transportation for copensation between points in Pennsylvania and will not engage in said transportation unless and until authorization is received fro the Pennsylvania Public Utility Coission. Applicant further certifies that it understands the requireents ofthe Pennsylvania Public Utility Coission, especially as they relate to safety and insurance and that it ay be subject to civil penalties, suspension or cancellation of the Certificate for failure to coply with Coission requireents. Applicant further certifies that it understands that it is subject to an annual assessent based upon its reported gross Pennsylvania intrastate revenues; said assessent to help defray expenses incurred in regulating Motor Coon and Motor Contract Carriers of Household Goods in Use; and acknowledges that failure to report revenue and pay its annual assessent ay result in civil penalties, suspension or cancellation ofthe certificate. Verification of Application I/We hereby state that the stateent(s) ade in this application is/are true and correct to the best of y/our knowledge and belief. The undersigned understands that false stateents herein are ade subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. (Print Nae) ^ (Signature) (Date) The verification ofthe application ust be copleted bythe applicant appearing on Line 1 ofthe application by the naed individual, all partners if a partnership, a eber (if a iiited liability copany), or by the President or Secretary (if a corporation). Revised 12/1/13

4 Business Entity Page 1 of 1 ff Pennsylvania VJM DEPARTMENTOFSTATE Corporations Online Services Corporations 1 Fors Contact Corporations Business Services Search By Business Nae By Business Entity ID Verify Verify Certification Online Orders Register for Online Orders Order Good Standing Order Certified Docuents Order Business List My Iages Search for Iages Date: 7/4/2014 Business Nae History Nae Business Entity Filing History (Select the link above to view the Business Entity's Filing History) HINDMAN & ISAACS MOVING & STORAGE, INC. Nae Type Current Nae Business Corporation - Doestic - Inforation Entity Nuber: Status: Entity Creation Date: Active 11/5/2001 State of Business.: Registered Office Address: Mailing Address: PA 110 ART-LIN DR BUTLER PA Butler No Address Copyright 2002 Pennsylvania Departent of State. All Rights Reserved. Privacy Policy Security Policy 7/4/2014

5 BICEHOUSE CONSULTING & SERVICES Your D.O.T. Copliance & Fuel Tax Service Attn: Kent Bicehouse -! 1887 Sandy,Lake-GC Road Jackson Center, PA D13 3DEQ DD01 fll3e 5fl53 POSTAL SSRVICC fy> tn j ^ U.S. POSTAGE PAID HftRRISVILLE.PA JUL 07.* M AMOUNT $6.70 r-o 000^!77-05 C cn 1 Property Carrier Application PENNSYLVANIA PUBLIC UTILITY COMMISSION BUREAU OF TRANSPORTATION & SAFETY P.O. BOX 3265 HARRISBURG, PA CD, 1 ' L C_" 'iili'iiilh-i'i''ii' i ll i ''iil'iii«i iiii' i i, ''!l''l'" i ]']j'i i 'i XT