Join P Logistics

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Name* This field is required.
First Name
Middle Name or Initial (optional)
Last Name
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Phone number* This field is required.Enter the best phone number to reach you
Area Code
Phone Number
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Email* This field is required.
example@example.com
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Current address* This field is required.
Street Address
Street Address Line 2
City
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Other
Country
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Have you been at that address for 3+ years?* This field is required.
Yes
No
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Enter any previous addresses where you have lived in the last 3 years
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Date of birth* This field is required.mm/dd/yyyy
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Place of birth* This field is required.City, State or Country
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Social security number* This field is required.
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Driver's license number* This field is required.
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Driver's license state of issue
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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Montana
Nebraska
Nevada
New Hampshire
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Ohio
Oklahoma
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Pennsylvania
Rhode Island
South Carolina
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Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
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Wyoming
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Add picture of current Driver's LicenseSENDING A PICTURE NOW WILL SPEED UP YOUR APPLICATION, but you can send it later if you like.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Add picture of SSN cardSENDING A PICTURE NOW WILL SPEED UP YOUR APPLICATION, but you can send it later if you like.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Add picture of Medical cardSENDING A PICTURE NOW WILL SPEED UP YOUR APPLICATION, but you can send it later if you like.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Driving Experience
Equipmt. type
Date from
Date to
Total miles
Straight Truck
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Semi-Trailer
Row 1, Column 0
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Straight Truck
Semi-Trailer
Equipmt. type
Row 0, Column 0
Date from
Row 0, Column 1
Date to
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Total miles
Row 0, Column 3
Equipmt. type
Row 1, Column 0
Date from
Row 1, Column 1
Date to
Row 1, Column 2
Total miles
Row 1, Column 3
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Have you had any traffic accidents in the last 3 years?* This field is required.
No
Yes, I'll explain
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Traffic accidents for past 3 yearsIf YES, please give date, location, injuries and fatalities (if any):
18
Have you had any traffic convictions in the last 3 years?* This field is required.Parking violations need not be disclosed
No
Yes, I'll explain
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Traffic convictions for past 3 yearsIf YES, please give date, location, charges and penalties:
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Have you ever been convicted of a Felony, DUI, or DWI?* This field is required.
No
Yes, I'll explain
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Felony convictionsIf YES, please list date of offense, any fines or time served:
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Has any license, permit, or privilege been suspended or revoked?* This field is required.
No
Yes, I'll explain
23
License suspensionsIf YES, please give reasons, dates and lengths of suspensions:
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Past employers and qualificationsList all employers and qualifications for the last 3 years (most recent first)
Company name
Date from
Date to
Phone number
Employer 1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Employer 2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
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Employer 3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Employer 1
Employer 2
Employer 3
Company name
Row 0, Column 0
Date from
Row 0, Column 1
Date to
Row 0, Column 2
Phone number
Row 0, Column 3
Company name
Row 1, Column 0
Date from
Row 1, Column 1
Date to
Row 1, Column 2
Phone number
Row 1, Column 3
Company name
Row 2, Column 0
Date from
Row 2, Column 1
Date to
Row 2, Column 2
Phone number
Row 2, Column 3
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Will you email us pictures of your ID documents?We will need a picture of your driver's license, SSN card, and medical card to fully process your application. One or more of those might be missing. Will you please email us those pictures at safety@primelogisticscorp.com after you submit your application?
YESNO
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Disclosures and AuthorizationsI authorize P LOGISTICS to perform the driving history and background checks described here.
P LOGISTICS may request from a consumer reporting agency and for employment-related purposes, a "consumer report(s)" (commonly known as "background reports") containing background information about you in connection with your employment, or application for employment, or engagement for services (including independent contractor or volunteer assignments, as applicable). 
HireRight, LLC ("HireRight") will prepare or assemble the background reports for the Company. HireRight is located and can be contacted at 100 Centerview Drive, Suite 300, Nashville, TN 37214, (800) 400-2761, www.hireright.com. 
The background report(s) may contain information concerning your character, general reputation, personal characteristics, mode of living, or credit standing. The types of background information that may be obtained include, but are not limited to: criminal history; litigation history; motor vehicle record and accident history; social security number verification; address and alias history; credit history; verification of your education, employment and earnings history; professional licensing, credential and certification checks; drug/alcohol testing results and history; military service; and other information. 
By my signature below, I authorize the preparation of background reports about me, including background reports that are "investigative consumer reports" by HireRight, and to the furnishing of such background reports to the Company and its designated representatives and agents, for the purpose of assisting the Company in making a determination as to my eligibility for employment or engagement for services (including independent contractor or volunteer assignments, as applicable), promotion, retention or for other lawful employment purposes. I understand that if the Company hires me or contracts for my services, my consent will apply, and the Company may, as allowed by law, obtain from HireRight (or from a consumer reporting agency other than HireRight) additional background reports pertaining to me, without asking for my authorization again, throughout my employment or contract period. 
By my signature below, I also promise that the personal information I provide with this form or otherwise in connection with my background investigation is true, accurate and complete, and I understand that dishonesty or material omission may disqualify me from consideration for employment. I agree that a copy of this document in faxed, photocopied or electronic (including electronically signed) form will be valid like the signed original. I further acknowledge that I have received additional state law notices that I have reviewed and read. 

Additional State Law Notices: 
MASSACHUSETTS: Upon request to the Company, you have the right to know whether the Company requested an investigative consumer report about you and, upon written request to the Company, you have the right to receive a copy of any such report. You also have the right to ask the consumer reporting agency (e.g., HireRight) for a copy of any such report. 
MINNESOTA: You have the right in most circumstances to submit a written request to the consumer reporting agency (e.g., HireRight) for a complete and accurate disclosure of the nature and scope of any consumer report the Company ordered about you. The consumer reporting agency must provide you with this disclosure within 5 days after (i) its receipt of your request or (ii) the date the report was requested by the Company, whichever date is later. 
NEW JERSEY: You have the right to submit a request to the consumer reporting agency (e.g., HireRight) for a copy of any investigative consumer report the Company requested about you. 
NEW YORK: You have the right, upon written request to the Company, to be informed of whether or not the Company requested a consumer report or an investigative consumer report about you. Shown above is the address and telephone number for HireRight, the consumer reporting agency used by the Company. You may inspect and receive a copy of any such report by contacting that consumer reporting agency. A copy of Article 23-A of the New York Correction Law is also provided below.
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Disclosures and AuthorizationsI authorize P LOGISTICS to access my FMCSA Pre-Employment Screening report.
IMPORTANT DISCLOSURE 
BACKGROUND REPORTS FROM THE PSP Online Service 
In connection with your application for employment with P LOGISTICS ("Prospective Employer"), Prospective Employer, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA). 
When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report. 
When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act. 
Neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication. 
Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report. 
The Prospective Employer cannot obtain background reports from FMCSA without your authorization. 
AUTHORIZATION 
If you agree that the Prospective Employer may obtain such background reports, please read the following and sign in the box provided. 
I authorize PRIME ("Prospective Employer") to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am authorizing the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee. 
I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication. 
I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear on my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report. 
I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this Disclosure and Authorization, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above. 
NOTICE: This form is made available to monthly account holders by NIC on behalf of the U.S. Department of Transportation, Federal Motor Carrier Safety Administration (FMCSA). Account holders are required by federal law to obtain an Applicant's written or electronic consent prior to accessing the Applicant's PSP report. Further, account holders are required by FMCSA to use the language contained in this Disclosure and Authorization form to obtain an Applicant's consent. The language must be used in whole, exactly as provided. Further, the language on this form must exist as one stand-alone document. The language may NOT be included with other consent forms or any other language. 
NOTICE: The prospective employment concept referenced in this form contemplates the definition of "employee" contained at 49 C.F.R. 383.5. 
LAST UPDATED 2/11/2016
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Signature* This field is required.
Clear
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Signed on today's date* This field is required.
Date
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Day
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