Owner Operator Annual Confirmation Please enable JavaScript in your browser to complete this form.First Name *Last Name * License License Layout Company Name *License Number *License Issue StateTerms & Conditions As an owner operator, I attest and affirm that the above information is true and accurate. I agree and acknowledge that it is my responsibility to update my company's driver roster in the event that I add any additional driver to the company. Failure to do so may result in non compliance with federal regulations and be subject to removal from the BRAVO Consortium. Signature Clear Signature Submit