PDT Drivers Certification of Violations

Drivers Certification of Violations
Name of Driver
Driver's License Number
I certify that the following is a true and complete list of traffic violations (other than parking tickets) for which I have been convicted or forfeited bond or collateral during the past 12 months.
Date

MonthDay Year
Date
Offense
Location
Type of Vehicle
Date

MonthDay Year
Date
Offense
Location
Type of Vehicle
Date

MonthDay Year
Date
Offense
Location
Type of Vehicle
If violations are listed above, I certify that I have not been convicted or forfeited bond or collateral on account of any violations required to be listed during the past 12 months.
(Date of Certification)

MonthDay Year
Date
Drivers Signature

Clear
Motor Carrier Name - Petroleum Distribution Transportation, LLC
Motor Carrier Address -11010 Coachlight St. San Antonio, TX 78216
Petroleum Distribution Transportation, LLC
Annual Review of Driving Record

This day I reviewed the driving record of the above named driver in accordance with part 391.25 of the Federal Motor Carrier Regulations. I considered any evidence that the driver has violated applicable provisions of the regulations and the hazardous materials regulations. I considered the drivers accident record and any evidence that he/she has violated laws governing the operation of commercial motor vehicles. I gave great weight to violations such as speeding, reckless driving, drug and alcohol violations that might indicate the driver has exhibited a disregard for the safety of the motoring public. In addition, I reviewed the driver certification of violations above this annual review form.
I find that:

the driver meets the minimum requirements for safe driving, orthe driver is placed on probation, orthe driver is disqualified to drive a commercial motor vehicle pursuant to 391.15
Date of Review

MonthDay Year
Date
Reviewed by: Signature

Clear
Petroleum Distribution Transportation, LLC
11010 Coachlight St, San Antonio, TX. 78216

Motor Carriers Name and Address
Should be Empty: