Place the adapter's tube length onto the pickup's gooseneck ball. Tighten the adapter to the ball with the protruding lever. Pull up on the adapter to verify that the ball and adapter are snugly pressed against each other.
Back the pickup truck under the towing item's connection point. Make sure the towing item's fifth wheel connection point is centered exactly above the adapter in the truck bed's middle area.
Carefully connect the towing item, or trailer's, fifth wheel connection point into the adapter. Attach the safety chains from the adapter to the connected trailer attachment. Verify that the chain connection is closed before driving.
Start the pickup truck and test the towing configuration by driving a short distance. The adapter should not alter how the vehicles move with each other. The feel of the towing process, while driving, should resemble a normal towing process without an adapter.