MVR - Motor Vehicle Records.

MVR - Motor Vehicle Records
AFFIDAVIT OF INTENDED USE
THIS FORM IS REQUIRED FOR OBTAINING YOUR MOTOR VEHICLE RECORDS. PLEASE COMPLETE THIS FORM ENTIRELY AND SIGN IT/DATE IT. YOUR MVR WILL BE ACCESSED BY AMERICAN EAGLE TRUCKLINE INC.

TO BE COMPLETED BY THE DRIVER
Name

First NameLast Name
Applying for:

Company driverOwner operator
CDL-A experience

0-5 months6 months - 1 year1-2 years2-5 years5 years+
CDL number
CDL state
CDL expiration

MonthDayYear
Date
Date of birth:

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
INFORMATION MAY BE USED ONLY FOR THE FOLLOWING APPROVED DRIVER PRIVACY PROTECTION ACT (DPPA) PURPOSES.

By an employer/agent or insurer to obtain or verify information on a Commercial License Holder.

Under the penalty of perjury, I attest that I shall not obtain, resell, transfer, or use the information in any manner prohibited by law. I understand that motor vehicle or driver records that are obtained, resold, or transferred for purposes prohibited by law may subject me to civil penalties under federal and state law.
Signature

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