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Moving & Storage Membership Application
Since the actions of one company can affect the reputation of the entire industry, as a condition of membership, all members of the PMSA must agree to abide by an enforceable code of conduct. The membership committee review of applications will include research of complaint history with regulatory and consumer agencies, and solicitation of comments from existing members.
If admitted to membership, applicant agrees and promises to pay the annual membership dues in a timely manner, abide by the bylaws and other policies and procedures as prescribed by the Board of Directors, subscribe to the Association’s Code of Ethics, and conduct business in an ethical manner consistent with the laws of the State of Pennsylvania and the United States of America, or any subdivision thereof. Failure to meet these obligations may result in suspension or termination of membership and forfeiture of all membership services. Membership will automatically renew annually unless cancelled in writing.

(Membership will be on probationary status for one year.)



Company Name

PA License #                                                DOT # 

Type of Company                                     

Names of all owners, partners or officers 

Name of on-site general manager 

Mailing address                                                                    Physical location 






Phone                                   Fax 

E-mail                                                      Website 

Number of Interstate Tractors            Trailers            Straight trucks            Vans 

Do you operate a property warehouse in PA?                       Self-Storage? 

Do you operate a record storage facility?

List any other states you conduct transportation or storage for hire  

List any van line affiliations 

List any additional interstate licenses 

Services provided: 

No services will be provided until application is approved. After submitting this application, please submit one year’s dues, and
proof of workmen’s compensation insurance.

You can pay your dues online here or mail to: 
     Pennsylvania Moving & Storage Associates
     c/o JWM Associates LLC 
     P.O. Box 526 
     Marlboro, NJ 07746

The undersigned warrants, represents, and promises that the information included with the application is true, accurate, and complete to
the best of the applicant’s knowledge and belief and further promises to uphold the Association’s membership requirement. I consent to
receive communications sent by, or on behalf of PMSA and its subsidiaries and affiliates concerning PMSA programs, services, and activities
via fax, E-mail, telephone, regular mail, or any other medium.

​____________________________________________________________________________________________________________________

TERMS OF ACCEPTANCE and SIGNATURE

I, the submitter of this application, warrant the truthfulness of the information provided herein and furthermore I agree to the PMSA Code of Ethics.

Electronic Signature:*
                                    Please type your First and Last Name









The cost of membership is based on your total gross operating revenue
This includes both local and interstate revenues.
Tier Level | Gross Operating Revenue | Dues
  1             Up to $150,000                 $ 175.00
  2            150,001 to 300,000            $ 225.00
  3            300,001 to 600,000            $ 325.00
  4            600,001 and over               $ 425.00
  Additional locations* $ 75.00
You can e-mail your proof of insurance to: dirjwm@verizon.net or regular mail to the address listed to the right. 
Same as Mailing Address
YesNo
YesNo
YesNo
*I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.
Household Goods
Office/Industrial
General Freight
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