The above named individual has made application with our Company for employment as a driver, or is being annual reviewed. The applicant has indicated that the driver's license listed above has been issued by a State agency and that it is in good condition
In accordance with Part 391.23 (a) (1) and (b) of the Federal Motor Carrier Regulations, we are required to make an inquiry into the driving history during the three preceding years in every state in which the applicant has held a motor vehicle operator's license during those three years.
Therefore, please certify to us a copy of the applicants driving record for the preceding three years, or certify that no record exists if that by the case.
In the event that this inquiry request does not satisfy your requirements for making such inquiries, please forward such forms to us for completion of our investigation in the driving history of this applicant.
In addition the above, I understand that a consumer report or an investigative consumer report may be requested that include information as to my character, work habits, job performance, and experience along with reasons for termination of my past employers. I understand that as directed by company policy and consistent with the job applied for, the company may request information for public and private sources about my workers compensation injuries, driving record, court records, education, credentials, credit, and references
Medical and workers compensation information will only be requested m compliance with the Federal Americans with Disabilities Act (ADA), and/or any other applicable State law.
I acknowledge that a telephonic facsimile (FAX) or photographic copy shall be as valid as the original. This release is valid for Federal State, County and Private Agencies.