COMMERCIAL DRIVER APPLICATION
FILL IN ALL BLANKS & PROVIDE ALL INFORMATION REQUESTED
If your above address is less than 3 years continue listing them below to cover the previous 3 year period
Drivers License Information
All licenses held, last 3 years
All Accidents, last 3 years (If none, write NONE)
List all Traffic Violations Convictions, last 3 years or attach MVR (If none, write NONE) You are certifying this information as true and accurate.
Last 10 years (383.35) - account for gaps between employers: (If owner, list carriers leased to)
“I certify that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.”
“I authorize this motor carrier and/or it’s agents to perform any/all investigations including but not limited to, Criminal Background checks, Consumer Credit checks, Motor Vehicle Record checks and Prior Employment verification's.”
As a prospective driver contractor, you have the right to review information provided by previous employers. You have the right to have errors in the information corrected by the previous employer(s) and for that previous employer(s) to re-send the corrected information to the prospective motor carrier; the right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information.
Drivers who have previous Department of Transportation regulated history in the preceding three years, and wish to review previous employer provided investigative information, must submit a written request to the prospective motor carrier, which may be done at anytime, including when applying or as late as thirty (30) days after being contracted with or being notified of denial of contract. The prospective motor carrier must provide this information to the applicant within five (5) business days of receiving the written request. If the prospective motor carrier has not yet received the requested information from the previous employer(s), then the five (5) business day deadlines will begin when the prospective motor carrier receives the requested safety performance history information. If the driver has not arranged to pick up or receive the requested records within thirty (30) days of the prospective motor carrier making them available, the prospective motor carrier may consider the driver to have waived their request to review the records. description)
CDL/HAZMAT ONLY - Controlled Substance and Alcohol Questionnaire
For driver applicants of commercial motor vehicles that require a Commercial Driver License (CDL) the
applicant must disclose their controlled substance and alcohol status per the requirements of 49 CFR part