LICENSE INFORMATION
Section 383 21 FMCSR states 'No person who operates a commercial motor vehicle shall at any tIme have more than one driver's license'. I certify that I do not have more than one motor vehicle license, the information for which is listed below.
DRIVING EXPERIENCE
ADDITIONAL DRIVING EXPERIENCE - (Optional)
EMPLOYMENT RECORD
Applicants that desire to drive in Intrastate/Interstate commerce must provide the following information on all employers during the previous three years. Please be specific on any employment held that required a commercial drivers license. Must list complete and accurate information.
Current/Last Employer
Employment
DRUG TESTING
Per FMCSA, All CDL drivers operating commercial motor vehicles (CMVs) greater than 26,000 GVWR on public roadways must be DOT drug and alcohol tested. This includes pre-employment, post accident, and periodic drug testing. All applicants must maintain negative testing results and must certify never to operate a commercial motor vehicle under the influence of drugs or alcohol.
TO BE READ AND SIGNED BY APPLICANT:
I authorize you to make sure investigations and inquiries to my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing Information in connection with my application.
In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also that I am required to abide by all rules and regulations of the Company.
I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of
investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:
• Review information provided by current/previous employers;
• Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and
• Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.
This signature certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge.
Note: A motor carrier may require an applicant to provide information in addition to the information required by the Federal Motor Carrier Safety Regulations. *
