MVR RELEASE CONSENT FORM

In conjunction with my employment, at Davis Trucking LLC
(Full name)
(employee/applicant name) Consent to the release of

my Motor Vehicle Record (MVR) to the company. I understand the company will use these records to evaluate my suitability to fulfill driving duties that may be related to the position for which I am applying. I also consent to the review, evaluation, and other use of any MVR I may have provided to the company.
This consent is given in satisfaction of Public Law 18 USC 2721 et. Seq "Federal Drivers Privacy Protection Act", and is intended to constitute "written consent" as required by this Act.
Employee/Applicant Signature

Clear
Date

MonthDayYear
Date
Date of Birth

MonthDayYear
Date
Social Security Number (last 4 digits)
Drivers' License Number
License Expiration Date

MonthDayYear
Date
Issuing State
Should be Empty: