PIN Request Form

NOTE: If you do not have an established account with CCD, your access to transactions will be limited.

  • Step 2: Review the information for accuracy.
  • Step 3: Print your PIN request form.
  • Step 4: Sign and Fax your Form to the fax number on the form.
  • Step 5: Once ODOT approves your PIN request you will receive an E-mail confirmation.

Questions? Call 503-378-6699, or contact us.

Step 1: Complete the PIN request form
CCD Account Number:  * Help
Carrier's Business Name: CCD Will Provide Name
Contact Phone No: * Ext:
Contact Name:  *
Business E-mail Address:  *
Confirm E-mail Address:  *
Effective Date:    

* = required

The PIN request application must be signed by an Owner, Partner, LLC Member/Manager, Corporate Officer, or someone possessing a Power of Attorney (POA must be on file or attached) or it will be returned.