Free template · Owner-operator settlements

The settlement statement every small carrier should be sending.

If you lease on owner-operators,49 CFR 376.12 requires an itemized settlement— every load, every deduction, spelled out. Here's a clean one you can copy. Fewer pay disputes, a paper trail that holds up, and owner-operators who actually trust your numbers.

Blue Ridge Freight LLC
MC 1148820 · USDOT 3417790 · Asheville, NC
Owner-Operator Settlement
Settlement #2026-014
Period Aug 3 – Aug 9, 2026
Pay date Aug 14, 2026
Settled toJ. Rivera — Unit 214
Leased owner-operator · Payee address on file
BasisPercentage of line-haul
Carrier retains 10%
Loads & revenue
LoadDel.LaneBrokerLine-haul
L-4471Aug 3Charlotte, NC → Atlanta, GATQL$1,850.00
L-4488Aug 5Atlanta, GA → Nashville, TNCoyote$1,420.00
L-4501Aug 7Nashville, TN → Louisville, KYEcho$980.00
Gross line-haul (3 loads)$4,250.00
Deductions — each itemized
DeductionReferenceAmount
Carrier fee — 10% of line-haulRate schedule−$425.00
Fuel advance — ComDataADV 08/04−$600.00
Physical damage + occ/acc insuranceWk 08/03−$210.00
Trailer rentalUnit T-77−$175.00
ELD serviceMonthly ÷ 4−$35.00
Permit and toll reimbursementTrip L-4501−$150.00
Total deductions−$1,595.00
Net settlementGross $4,250.00 − deductions $1,595.00
$2,655.00
Owner-operator — reviewed & accepted
Carrier representative · date

What 49 CFR 376.12 actually expects

The truth-in-leasing rule. Plain-language summary, not legal advice — check your lease and counsel.

§ 376.12(d)

State the compensation

How the O/O is paid — percentage, per-mile, or flat — has to be clearly specified. Show the math on the settlement.

§ 376.12(h)

Itemize every chargeback

Any deduction from the O/O's pay must be spelled out, with the O/O able to see the documents behind it. No mystery line items.

§ 376.12(g)

Let them verify the rate

The O/O can request the rated freight bill the pay is computed from. Keep it attached or on request.

§ 376.12(k)

Account for escrow

If you hold a reserve, the statement must show the balance, what came out, why, and the terms for returning it.

Shared by Iron Wing Dispatching — a small dispatch outfit that got tired of settling owner-operators in a spreadsheet. Use this template freely. Sample figures are illustrative. This is general guidance, not legal advice — confirm your settlement practices against 49 CFR 376.12 and your own lease and counsel.

Stop building these by hand in Kelévo.

Import a rate confirmation, run the load, and Kelévo turns delivered freight into a 376.12-ready settlement in one click — then emails it to your owner-operator and your accountant. Built for small carriers running 2–10 trucks.

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