Do I need to weld this or drill holes in my frame?

No welding or drilling. This mounts at your truck's factory attachment points — bolt it down with basic hand tools and you're done.

Will I need fasteners beyond what comes in the box?

The hitch assembly is included. You'll use your truck's existing frame bolts — no additional hardware required for mounting.

Can I use any standard hitch ball with this?

Yes. This is a standard receiver hitch — any ball, ball mount, or cargo carrier with a matching receiver pin will work.