EMPLOYMENT HISTORY
All applicants desiring to drive a commercial motor vehicle (CMV), for intrastate or interstate commerce, must provide an additional 7 years of information on those employers for whom the applicant operated a CMV.
(NOTE: List employers in reverse order, starting with the most recent. Add another page if necessary)
I have read and understood the preceding Disclosure to Customer, Under the Fair Credit Reporting Act, FCRA, 15 U.S.C. 1681 et seq., the regulations applicable to federal Department of Transportation’s Federal Motor Carriers Safety Administration including The Americans with Disability Act and all other applicable federal state and local laws. Hereby authorize and permit the above named company to obtain information about me where permitted which may pertain to my employment records driving history, driving performance and safety history, criminal history, credit history, civil records, workers compensation, alcohol and drug testing, verification of my academic and or professional credentials, and information and copies of documents from any military service records.
I understand an investigation consumer report may include information as to my character, general reputation, personal characteristics, an motive living that may be obtained by interviews with individuals who may have knowledge concerning any such items of information. I authorized information to be obtained from my former employers to satisfy driver qualification regulations.
DOT Drivers: I understand that title 49 of the federal code of regulations requires my perspective employer and or its agents may contact all former employers of a driver within the last three years under the regulations of the Department of Transportation. Information such as dates of employment position accident history as well as information pertaining to my drug and alcohol test history maybe requested from each employer in accordance with Section 391.23 and CFR 40.25.
By signing below I consent to and authorize the gathering of this information by my perspective employer or employer and those who my perspective employer or employer has engaged to request an obtain this information including former employers, and or from a consumer reporting agency, such as iiX, a Verisk Analytic Business.
I understand and acknowledge that the information provided in the consumer report or investigative Consumer Reports may assist my employer or perspective employer to make a determination regarding my suitability as an employee.
Further I understand that under FCRA, in the event of adverse action, I may request a copy of any consumer report from the consumer reporting agency that compiled the report , after I have provided proper identification.
I agree that a copy of this authorization has the same effect as the original. Where permitted, this authorization shall remain in effect over the course of my employment and reports may be ordered periodically during the course of my employment.