Skip to content
Call us today 1.980.999.8484
FacebookEmail
Transportation Advisors Logo Transportation Advisors Logo Transportation Advisors Logo
  • Home
  • Who We Are
  • Services
  • Testimonials
  • Resources & Videos
  • Contact

Application for Driver Position

Application for Driver PositionJon Singer2022-03-08T11:48:29-05:00

Step 1 of 17

5%
  • Hidden
  • Hidden
  • Hidden
  • Please recheck your link or contact the company that provided the link.
  • Driver Application for Elder Charters

    910-751-2228

  • Driver Application for Rochester Shuttle Express

    Rochester Shuttle Express
    1-888-663-3770

  • Driver Application for Fitzgerald Brothers

    Fitzgerald Brothers

  • Driver Application for Majestic Limousine Service

    Majestic Limousine Service
    1816 Fuller Rd
    West Des Moines, IA 50265
    515-650-5555

  • Driver Application for Ambassador Global Chauffeur

    Ambassador Global Chauffeur
    3355 Lenox Rd Suite 750
    Atlanta, GA 30326
    404-621-2544

  • Driver Application for Dulles Limousine, LLC & Dulles Luxury Coach, LLC

    Dulles Limousine, LLC
    Dulles Limousine, LLC
    13827 Redskin Dr
    Herndon, VA 20171

    Dulles Luxury Coach, LLC
    Dulles Luxury Coach, LLC
    13829 Redskin Dr
    Herndon, VA 20171

  • Driver Application for Aadvanced Limousines

    Aadvanced Limousines

    8614 Southeastern Ave.
    Indianapolis, IN 46239
    (317) 716-1201

  • Driver Application for Blue Lakes Charters

    Blue Lakes Charters Logo

    12154 N. Saginaw Rd.
    Clio, MI 48420
    800-282-4287

  • Driver Application for Beat the Street

     Beat the Street Logo

    Nashville TN 37219
    407-614-1857

  • Driver Application for Renee’s Limousines

     Renee’s Limousines Logo

    12813 Industrial Park Blvd.
    Plymouth, MN 55441

  • Driver Application for Overland Transportation Services LLC

    3119 Merriam LN
    Kansas City, KS 66106
    913-381-3504

  • Driver Application for CTA Worldwide Chauffeured Transportation

     CTA Worldwide Chauffeured Transportation Logo

    1202 Hallmark Drive # 204
    San Antonio, Texas 78216
    210-829-8608

  • Driver Application for Executive Limousine & Coach Inc

    Executive Limousine & Coach Inc

    2550 Eastman Ave Ste 6
    Ventura, CA 93003
    805-658-7558

  • Driver Application for For Hire Transportation Management Services

    For Hire Transportation Management Services

    2450 Pleasantdale Rd
    Atlanta, GA 30340
    404-747-8096

  • Driver Application for Atlantic Limousine & Transportation

    Atlantic Limousine & Transportation

    2450 Pleasantdale Rd
    Atlanta, GA 30340
    770-751-7078

  • Driver Application for Network Transportation

    Network Transportation

    10311 Orangewood Blvd
    Orlando, FL 32821
    407-422-2522

  • Driver Application for Destination MCO

     Destination MCO

    10311 Orangewood Blvd
    Orlando, FL 32821
    407-422-2522

  • Driver Application for Best Transportation Inc.

    Best Transportation

    4628 Crossroads Industrial Drive
    St. Louis, MO 63044
    314-989-1500

  • Driver Application for NW Navigator Luxury Coaches LLC

    NW Navigator

    13940 N Rivergate Blvd
    Portland, OR 97203
    (503) 780-5100

  • Christian Bros

    Christian Bros

    8745 Old State Rd.
    Holly Hill, SC 29059
    803-682-5073

  • Starline Collection

    Starline Collection

    9801 Martin Luther King Jr Way S
    Seattle WA 98118
    206-763-5817

  • DTS Transportation

    DTS Transportation logo

    2211 Spencerville Rd
    Spencerville, MD 20868
    800.914.2855

  • Royal Parking Inc
    DBA Ecostyle

    Ecostyle logo

    1312 Kirkland Road Suite 117
    Raliegh, NC 27603
    (919) 890-3839

  • Chariots of Hire Inc

    Chariots of Hire

    1204 Topside Road
    Louisville, TN 37777
    (865) 522-8108

  • Driver Application for Adventures By Dawn LLC
    DBA Adventure Tours

     Adventures By Dawn  Logo

    Charlotte, NC
    (301)868-1141

  • Driver Application for Adventures By Dawn LLC
    DBA Adventure Tours

     Adventures By Dawn  Logo

    17517 B Indian Head Hwy
    Accokeek, MD 20607
    (301)868-1141

  • Driver Application for Umbrella Buses Inc.

    Umbrella Buses Inc.

    419 W. Landstreet Rd.
    Orlando, FL 32834

  • Driver Application for Carolina Limousine & Coach

    Carolina Limousine & Coach logo

    7269 SC-707
    Myrtle Beach, SC 29588
    (843) 294-5466

  • Driver Application for Quick-Livick Inc
    DBA Quick's Bus Company

    Quick's Bus Company logo

    2309 Poplar St
    Staunton, VA 24401
    (540) 886-6297

  • Driver Application for Appellation Tours Inc
    DBA Beau Wine Tours

    Beau Wine Tours logo

    21707 8th Street East
    Sonoma, CA 95476
    (800) 387-2328

  • Driver Application for PREMIER Transportation Company

    PREMIER Transportation logo

    1500 Breda Drive
    Knoxville, TN 37918

    1619 Shepherd Rd.
    Chattanooga, TN 37421
    (865) 694-0304

  • Driver Application for Carreras Tours LLC

    Carraras

    408 E Transit St
    Ontario, CA 91761
    (909) 467-4949

  • Driver Application for

    DEMO

    ADDRESS
    CITY, STATE ZIP
    PHONE

  • Driver Application for Gentry
    DBA Olympus Car and Coach

    2519 Mitchell St
    Knoxville, TN 37917
    (865) 522-2796

  • Driver Application for Going Coastal

    4211 Fellowship Rd
    N. Charleston SC 29418
    843-216-8483

  • Driver Application for Peak Limo

    2300-C Stevens Mill Rd
    Charlotte, NC 28104
    704-568-1200

  • Driver Application for North Point

    1454 Willingham Dr.
    Atlanta, GA 30344
    678-935-5000

  • Driver Application for Atlanta Elite

    1810 Water Place SE
    Suite 140
    Atlanta, GA 30339
    (770) 955-4565

  • Driver Application for Charlotte Scale

    1510 Ameron Dr
    Charlotte, NC 28206
    704-376-8496

Save and Continue Later
  • Register Immediately on  

    https://clearinghouse.fmcsa.dot.gov/
Save and Continue Later
  • Applicant Information

  • (The Age Discrimination of Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than 70 years of age.)

  • Current & Previous Three Years Addresses

  • Address From Date (MM/DD/YYYY) To Date (MM/DD/YYYY) Actions
         
    There are no Entries.

    Maximum number of entries reached.

  • Note: Please enter the continuous addresses for the past 3 years to go to the next step.

Save and Continue Later
  • Education

    • Type Of School

    • Name Of School

    • Location

    • Years Completed

    • Major & Degree

    • High School

    • College

    • Business/Trade School

    • Professional School

Save and Continue Later
  • Employment History

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
Save and Continue Later
  • Employment History

  • A COMPLETE employment application is required. List all employment for the past three (3) years, including any unemployment or self-employment periods, volunteer experience, and all commercial driving experience for the past ten (10) years. Failure to provide contact information or a complete 10-year history may result in disqualification of the application. Information provided may be used and the applicant’s prior employers may be contacted for the purpose of investigating the applicant’s safety performance history information as required by 49 CFR §391.23.
  • Date (MM/DD/YYYY) From Date (MM/DD/YYYY) To Company Name Actions
         
    There are no Entries.

    Maximum number of entries reached.

  • Note: List all employment for the past 3 years, including any unemployment or self-employment periods, volunteer experience, and all commercial driving experience for the past ten (10) years.

Save and Continue Later
  • PLEASE RETURN AS SOON AS POSSIBLE!!!

    **FOR OFFICE STAFF TO FILL OUT – APPLICANT PRINT NAME, SIGN AND DATE AT BOTTOM ONLY **

    To (Previous Employer):_______________________________

    Applicant Name:______________________________________

    DATE:_______________________________

    SS#:_________________________________

    The person listed above has applied to this company. Your firm is listed by the applicant as a previous employer. Please complete the following items and return to us as soon as possible.
    Carrier Representative: Transportation Advisors

    Dates of Employment: From________ To________ Position:____________________________

    Three-year Accident History

    Date City/State # Injuries # Fatalities Hazmat? Preventable
               
               
               
               

    Department of Transportation regulations 40 CFR Part 40.25 h require that you provide the following information:
    In the past three years, has the individual listed below ever:
    Had a verified positive drug test result?    ________Yes    ________No
    Had an alcohol test result with a breath alcohol concentration of .04 or greater?    ________Yes   ________No
    Refused to submit to an alcohol or drug test?    ________Yes    ________No
    Had any other violations of DOT agency drug and alcohol testing regulations?    ________Yes    ________No

    If any of the above questions were answered yes, please provide the following:

    ______________________________
    Substance Abuse Professional

    ______________________________
    Telephone

    _______________________
    Date Referred

    _________________________________
    Address

    ______________________
    City

    _______________________
    State

    ________________
    Zip

    ____________________________________
    Signature of person supplying information

    ______________________________
    Title

    ____/_____/_______
    Date

  • APPLICANT RELEASE AND CONSENT:

  • do hereby authorize my previous employers to release and forward all information regarding my alcohol and controlled substance testing and all other records of employment to the above-named carrier in connection with my application for employment. I release my former employers from any and all liability of any type as a result of providing the above information.

  • Reset signature Signature locked. Reset to sign again
  • MM slash DD slash YYYY
Save and Continue Later
  • Driving Experience

  • Straight Truck
  • Tractor & Semi-Trailer, Two or Three Trailers
  • Mini Bus
  • Motor Coach
  • Other
  • Accident Record for past three (3) years

  • Date of AccidentNature of Accidents (Head on, rear end, etc.)Location of Accident# of Fatalities# of People InjuredInvolved CMV? 
  • Traffic Convictions and Forfeitures for the last three (3) years (INCLUDING tickets from an accident, EXCLUDING parking violations)

  • DateLocationChargePenalty / Points 
  • DRIVER REQUIREMENTS:

    Parts 383 and 391 of the Federal Motor Carrier Safety Regulations contain certain driver licensing requirements that you as a driver must comply with, including the following:

    1) POSSESS ONLY ONE LICENSE: You, as a commercial vehicle driver, may not possess more than one motor vehicle operator's license.

    2) NOTIFICATION OF LICENSE SUSPENSION, REVOCATION OR CANCELLATION: Sections 391.15(b)(2) and 383.33 of the Federal Motor Carrier Safety Regulations require that you notify your employer the NEXT BUSINESS DAY of any revocation or suspension of your driver's license. In addition, Section 383.31 requires that any time you violate a state or local traffic law (other than parking), you must report it within 30 days to: 1) your employing motor carrier, and 2) the state that issued your license (If the violation occurs in a state other than the one which issued your license). The notification to both the employer and the state must be in writing.

    3) CDL DOMICILE REQUIREMENT: Section 383.23(a)(2) requires that your commercial driver’s license be issued by your legal state of domicile , where you have your true, fixed, and permanent home and principal residence and to which you have the intention of returning whenever you are absent. If you establish a new domicile in another state, you must apply to transfer your CDL within 30 days.

    The following license is the only one I will possess:

  • MM slash DD slash YYYY
  • Driver’s License list EACH driver’s license held in the past three(3) years

  • StateTypeEndorsementsLicense NumberExpiration Date 
  • Drop files here or
    Max. file size: 50 MB, Max. files: 2.
    • Drop files here or
      Max. file size: 50 MB, Max. files: 2.
      • MM slash DD slash YYYY
      • Drop files here or
        Max. file size: 50 MB.
        • Drop files here or
          Max. file size: 50 MB.
          • MM slash DD slash YYYY
          • Max. file size: 50 MB.
          Save and Continue Later
          • Rights

            Pursuant to 49CFR, part 391.23 (j), you have the following rights regarding investigative information

            • The right to review information provided by previous employers.
            • The right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to the prospective employer.
            • 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.
          • To Be Read and Signed by Applicant

          • This 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. I authorize you to make such investigations and inquire of 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 connections 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.
          • Reset signature Signature locked. Reset to sign again
          • MM slash DD slash YYYY
          Save and Continue Later
          • Rights

            Pursuant to 49CFR, part 391.23 (j), you have the following rights regarding investigative information

            • The right to review information provided by previous employers.
            • The right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to the prospective employer.
            • 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.
          • If you wish to review previous employer-provided investigative information you must submit a written request to the prospective employer, which may be done at any time, including when applying or as late as 30 days after being employed or being notified of denial of employment. The prospective employer must provide this information to the applicant within five business days of receiving the written request. If the prospective employer has not yet received the requested information from the previous employer(s), then the five-business days deadline will begin when the prospective employer received the requested safety performance history information. If the driver has not arranged to pick up or received the requested records within the thirty days of the prospective employer making them available, the prospective motor carrier may consider the driver to have waived his/her request to review the records.

            Drivers wishing to request correction of erroneous information in records must send the request for the correction to the previous employer that provided the records to the prospective employer. The previous employer must either correct and forward the information to the prospective motor carrier employer, or notify the driver within 15 days of receiving a driver's request to correct the data that it does not agree to correct the data. If the previous employer corrects and forwards the data as requested, that employer must also retain the corrected information as part of the driver's safety performance history record and provide it to subsequent prospective employers when requests for this information are received. If the previous employer corrects the data and forwards it to the prospective motor carrier employer, there is no need to notify the driver.

            Drivers wishing to rebut information in records must send the rebuttal to the previous employer with instructions to include the rebuttal in that driver's safety performance history.
          • Reset signature Signature locked. Reset to sign again
          • MM slash DD slash YYYY
          Save and Continue Later
          • DRUG & ALCOHOL CLEARINGHOUSE CONSENT FOR LIMITED QUERIES

            NOTICE TO DRIVER: The Commercial Driver's License (CDL) Drug & Alcohol Clearinghouse is a federal database containing information about CDL drivers who have violated the Federal Motor Carrier Safety Administration's (FMCSA's) drug or alcohol regulations in 49 CFR Part 382. Whether you have committed such a violation or not, each motor carrier for whom you drive is required to check whether the Clearinghouse has any information about you, both at the time of hire and annually. When conducting an annual inquiry, the motor carrier has the option to request a "limited" report that only indicates whether the Clearinghouse has any information about you; it does not release any violation or testing information. Before a motor carrier may request a limited report, they must have your written authorization, per §382.701 (b). This authorization may be valid for more than one year. If a limited query ever reveals that the Clearinghouse has information about you, you will be required to log in to the Clearinghouse website within 24 hours to grant electronic consent for the motor carrier to obtain your full Clearinghouse record.

            NOTICE TO MOTOR CARRIER: This consent form authorizes you to run a "limited query" to check whether the Clearinghouse has information about the driver identified below. If it does, then you must obtain a full Clearinghouse record within 24 hours, per §382.701 (b). This consent form must be retained until 3 years after the date of the last limited query you perfonn for this driver, based on the authorization below.

          • hereby authorize to conduct limited annual queries of the FMCSA's Drug & Alcohol Clearinghouse, to determine if a Clearinghouse record exists for me. This consent is valid from the date shown below until my employment with the above-named motor carrier ceases or until I am no longer subject to the drug and alcohol testing rules in 49 CFR Part 382 for the above-named motor carrier.

            I understand that if any limited query reveals that the Clearinghouse contains information about me, I must grant electronic consent within 24 hours, via the Clearinghouse website, for the motor carrier to obtain my full Clearinghouse record. Refusal to provide such consent will result in my removal from safety-sensitive duties.

          • Reset signature Signature locked. Reset to sign again
          • MM slash DD slash YYYY
          Save and Continue Later
          • Electronic Disclosure Form

            DISCLOSURE TO EMPLOYMENT APPLICANT & STAFF REGARDING INITIAL & ANNUAL PROCUREMENT OF INVESTIGATIVE & DRIVER’S LICENSE REPORTS: Please be advised that we may obtain an investigative report including information as to your character, general reputation, and personal characteristics. This information may be obtained by contacting your previous employers or references supplied by you. Please be advised that you have the right to request, in writing, within a reasonable time, that we make a complete and accurate disclosure of the nature and scope of the information requested. Such disclosure will be made to you within 5 business days of the date on which we receive the request from you or within 5 business days of the time the report was first requested. If the individual being reported on is under the age of 18, a guardian’s signature must accompany the individual’s signature on this form. By signing below, you hereby authorize us to obtain a driver’s license, criminal background check, education verification, credit report, past employment details, or any other information needed for employment. We, the employer, reserve the right to pull an updated report at our discretion for a period of five years or until employment is terminated.

            Fair Credit Reporting Act

            A Summary of Your Rights
            Under the Fair Credit Reporting Act

            The Federal Fair Credit Reporting Act (FCRA) is designed to promote accuracy, fairness, and privacy of information in the files of every “consumer reporting agency” (CRA). Most CRA’s are credit bureaus that gather and sell information about you – such as if you pay your bills on time or have filed bankruptcy – to creditors, employers, landlords, and other businesses. You can find the complete text of the FCRA, 15 U.S.C. section 1681-1681u. The FCRA gives you specific rights as outlined below. You may have additional rights under state law. You may contact a state or local consumer protection agency or state attorney general to learn those rights.

            • You must be told if information in your file has been used against you.
            • You can find out what is in your file.
            • You can dispute inaccurate information with the CRA.
            • Inaccurate information must be corrected or deleted.
            • You can dispute inaccurate items with the source of the information.
            • Outdated information may not be reported.
            • Access to your file is limited.
            • Your consent is required for reports that are provided to employers or reports that contain medical information.
            • You may choose to exclude your name from CRA lists for unsolicited credit or insurance offers.
            • You may seek damages from violators.

            For questions and concerns regarding CRA’s, contact:
            Federal Trade Commission – Consumer Response Center FCRA
            Washington, DC 20580
            202-326-3761

            In compliance with consumer reporting and privacy legislation, I having signed below, authorize Transportation Advisors, Datasource Background Screening Service and any of their agents on behalf of the company listed above to acquire information on my behalf:

          • Reset signature Signature locked. Reset to sign again
          Save and Continue Later
          • Pre-Employment Urinalysis Consent Agreement Drug & Alcohol Testing Consent Agreement Physical Examination Statement

            ALCOHOL & DRUG SCREENING REQUIREMENT: Controlled Substance and Alcohol Use Testing under Part 382 of the Federal Motor Carrier Safety Regulations apply to all applicants and drivers of . This consent agreement outlines what notification and testing is required under this Part by the FMCSR’s, and by our Company.
            A Medical Review Officer will maintain the results of all controlled substance tests and positive alcohol confirmation tests. Both Negative and positive results will be reported to . A positive test for alcohol or controlled substances will disqualify a driver from the operation of a commercial motor vehicle. Driver’s who test positive for controlled substances have 72-hours to request that their split sample be tested. Positive alcohol screening results in an automatic re-testing. Several conditions require testing under Part 382. They are as follows:

            Types of Controlled Substance Testing:

            • Pre-Employment
            • Random Selection
            • Reasonable Suspicion/Cause
            • Post Accident
            • Return to Duty
            • Follow-Up
            Test performed by split-sample urinalysis.

            Types of Alcohol Testing:

            • Random Selection
            • Reasonable Suspicion/Cause
            • Post Accident
            • Return to Duty
            • Follow-Up
            Test performed by saliva or breath alcohol analysis and may require confirmation test.

            NOTICE MUST BE GIVEN UNDER PART 382.113: Before performing an alcohol or controlled substances test under this part, each employer shall notify a driver that the alcohol or controlled substances test is required by this part. No employer shall falsely represent that a test is administered under this part.

            PHYSICAL EXAMINATION AGREEMENT: Physical exams are required by the FMCSR’s for commercial drivers. The driver is responsible to keep their physical current. The physical must be completed by certified DOT Examiner.

            APPLICANT AGREEMENT: As an applicant for employment with , I understand that Controlled Substance, Alcohol Testing and physical examinations as described above are a condition of my employment.

          • Reset signature Signature locked. Reset to sign again
          • MM slash DD slash YYYY
          Save and Continue Later
          • Consumer Report Disclosure and Release

            In connection with your employment or application for employment (including contract for services), consumer reports may be requested from any consumer reporting agency. These reports may include the following types of information: names and dates of previous employers, reason for termination of employment, work experience, accidents, academic history, professional credentials, and drugs/alcohol use. Such reports may contain public record information concerning your driving record, workers' compensation claims, credit, bankruptcy proceedings, criminal records, etc., from federal, state and other agencies which maintain such records; as well as information concerning previous driving record requests made by others from such state agencies and state provided driving records.

            You have the right to make a request to the consumer reporting agency, upon proper identification, the nature and substance of all information in its files on you at the time of your request, including the sources of information and the recipients of any reports on you that the consumer reporting agency has previously furnished within the three-year period preceding your request. The contact information for the consumer reporting agency will be provided to upon request.

            I AUTHORIZE, WITHOUT RESERVATION, COMPANY NAME, AND/OR ANY PARTY OR AGENCY CONTACTED BY COMPANY NAME, TO FURNISH THE ABOVE MENTIONED INFORMATION. THIS AUTHORIZATION DOES NOT APPLY TO DRUG AND ALCOHOL INFORMATION OBTAINED UNDER PART I.

            I hereby consent to your obtaining the above information from a consumer reporting agency and/or any previous employer, and I agree that such information which any consumer reporting agency has or obtains, and my employment history (not DOT Drug and Alcohol information with a specific consent by me) with you if I am hired, will be supplied by and/or the consumer reporting agency to other companies which subscribe to said consumer reporting agency. I hereby authorized procurement of consumer reports(s). If hired or contracted this authorization, for Part II reports only, shall remain on file and shall serve as ongoing authorization for you to procure consumer reports at any time during my employment or contract period.

          • Reset signature Signature locked. Reset to sign again
          • MM slash DD slash YYYY
          Save and Continue Later
          • IMPORTANT DISCLOSURE

            REGARDING BACKGROUND REPORTS FROM THE PSP Online Service

            In connection with your application for employment with (“Prospective Employer”), Prospective Employer, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA).

            When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report.

            When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act.

            Neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication.

            Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report.

            The Prospective Employer cannot obtain background reports from FMCSA without your authorization.

            AUTHORIZATION

            If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:

            I authorize (“Prospective Employer”) to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am authorizing the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee.

            I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication.

            I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear on my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report.

            I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this Disclosure and Authorization, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above.

          • Reset signature Signature locked. Reset to sign again
          • MM slash DD slash YYYY
          • NOTICE: This form is made available to monthly account holders by NIC on behalf of the U.S. Department of Transportation, Federal Motor Carrier Safety Administration (FMCSA). Account holders are required by federal law to obtain an Applicant’s written or electronic consent prior to accessing the Applicant’s PSP report. Further, account holders are required by FMCSA to use the language contained in this Disclosure and Authorization form to obtain an Applicant’s consent. The language must be used in whole, exactly as provided. Further, the language on this form must exist as one stand-alone document. The language may NOT be included with other consent forms or any other language.

            NOTICE: The prospective employment concept referenced in this form contemplates the definition of “employee” contained at 49 C.F.R. 383.5.

          Save and Continue Later
          • COMPANY NAME:

            DRIVER NAME: {gfef_decrypt_8}

            FEDERAL MOTOR CARRIER SAFETY REGULATIONS

            *Required for all drivers.

            I {id:8}, hereby acknowledge that I have access to a copy of the Federal Motor Carrier Safety Regulations available to me at the company office. In addition a copy of regulations are available at https://www.law.cornell.edu/cfr/text/49/subtitle-B/chapter-III/subchapter-B to view electronically and free of charge.

            I agree to familiarize myself with the Federal Motor Carrier Safety Regulations of the US Department of Transportation, Subchapter B, Chapter 3, Title 49.

            Save the above link for your records

          • Reset signature Signature locked. Reset to sign again
          • MM slash DD slash YYYY
          Save and Continue Later
          • Are you ready to move forward with this applicant? Click this link: http://www.theadvisors.org/drugtestbackgroundrequest/

          • Please only click Submit once. It will take a little bit of time to process.

          Save and Continue Later
          © Copyright Transportation Advisors. All Rights Reserved.
          FacebookEmail
          Page load link
          Go to Top