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Portable/Mobile Equipment Change Form

Use this form to report additions or deletions to the list of portable or mobile equipment you have listed with the IMLRMA, or to add/delete/change equipment you may rent or lease.

  1. Complete the Portable/Mobile Equipment Change Form by selecting the appropriate version of the form above.
  2. Make/save a copy of the completed form for your own records.
  3. Print and fax a copy of the completed form to (217) 443-0927, or
  4. Mail the completed form to:
    • IMLRMA
      c/o CCMSI
      2 East Main Street
      Danville, IL 61832
  5. Attach the form to an email and send to
  6. If you have problems with or questions about the form, please contact us at: (800) 252-5051.
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