Supply Partner Onboarding

1099 Contractor Driver Application

Submit your credentials and vehicle documentation to drive with Addis Mobility

Tax Filing Structure *

Owner / Authorized Driver Full Name *

Email Address *

Phone Number *

Driver SSN *

Confirm SSN *

Driver Personal Residential Address

Street Address *

Apt / Suite / Unit

City *

State *

Zip Code *

License Number *

License Class *

Make *

Model *

Year *

Plate # *

Copy of Driver's License (Class D) *

License Expiration *

Vehicle Registration Certificate *

Registration Expiration *

Personal Auto Liability Insurance Policy *

Insurance Expiration *

Password *

Confirm Password *