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Click here or scroll down to respond to this candidateRyder Integrated Logistics, Inc.DOT#Street Address 0Street Address NW 105th StreetMiami, FL Street Address
Street Address -06-2024 9:46:02AM CDTIntelliAppPersonal InformationName Bud Robert MoyerCurrent Address 1225 Stoney Mountain RoadCity, State/Province Zip/Postal Martinsville, VA 24112 Country United StatesResidence 3 years or longer (If No,previous addresses shown below)YesSSN/SIN 2200Date of BirthPrimary Phone PHONE NUMBER AVAILABLECell Phone PHONE NUMBER AVAILABLEPreferred method of contact Cell PhoneBest time to contact you AnyEmail EMAIL AVAILABLECompany QuestionsGENERAL INFORMATIONApplicant Type: Truck DriverIf you answered YES to the questionabove, will you require now or in the nearfuture employment visa sponsorship (i.e.,H-1B visa)?Are you currently employed? YesWhat date did your last employment end?Do you read, write, and speak English? YesEnter start and end dates, location,position, and reason for leaving:Do you have a current TWIC card? NoExpiration date:Have you ever been known by any othername?No1Enter name:Please enter the names of any relativesemployed here:NoneDRIVING EXPERIENCEFor each class of equipment, enter type of equipment (van, reefer, tank, etc.), start and end dates, and approximate number of total miles. If no experience in a class, enter"NONE".Straight Truck Van 3KTractor and Semi-Trailer Van 800KReefer 200KCargo master Crane 200KTractor - Two Trailers 0Other 0Which safe driving awards do you hold andfrom whom?3 yr safe driving -BB trucking 2024EQUIPMENT (OWNER/OPERATORS ONLY)Equipment Description (Tractor):Type:Year:Make:Model:Color:VIN:WeightMileageFifth Wheel HeightFirst Reference:Have you completed your registration forthe FMCSA Drug & AlcoholClearinghouse?YesApplicant Workflow ID 3634025Person ID 2340832System ID 36340252LicensesLicense Number 602Licensing Authority VACountry USLicense Class Class AOriginal Issue Date 11-25-2020License Expiration Date 06-25-2025DOT Medical Card Expiration Date 03-01-2025Current License YesCommercial Driver License YesEndorsements NoneRestrictionsNo Night Driving NoCorrective Lenses NoNo Air Brakes NoNo Manual Transmission NoOther Restriction NoEmployment / UnemploymentBb TruckingCompany Bb TruckingContact / Supervisor NameStart Date 11-2018End Date 07-2024Address 6147 TECHNOLOGY AveCity, State/Province Zip/Postal Kalamazoo, MI 49009 Country United StatesPhone PHONE NUMBER AVAILABLEPosition Held Driver mentor, yard supervisor, contract mail truck driverReason for leaving? Company lost bid to renew contract with postal serviceWere you terminated/discharged/laid off? NoIs this your current employer? NoYes3May we contact this employer at this time?Did you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?YesDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven 48 states but primary east coastMiles driven weekly 2500-3000Pay Range (cents/mile) $36.50 hourlyMost common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreLogistics & Distribution ServicesCompany Logistics & Distribution ServicesContact / Supervisor NameStart Date 03-2015End Date 07-2024Address 1755 Purina WayCity, State/Province Zip/Postal Sparks, NV 89431Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held Otr truck driverReason for leaving? more reliable equipment. Better schedule Were you terminated/discharged/laid off? NoIs this your current employer? YesMay we contact this employer at this time? YesDid you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?Yes4Did you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven Continental Usa but primarily east coast Miles driven weekly 3000-3500Pay Range (cents/mile) .45- .50 cpmMost common truck driven Conventional TractorMost common trailer Reefer TrailerTrailer length 53 feet or moreLogistics & Distribution ServicesCompany Logistics & Distribution ServicesContact / Supervisor NameStart Date 03-2015End Date 06-2017Address 1755 Purina WayCity, State/Province Zip/Postal Sparks, NV 89431Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held otr/regional driverReason for leaving? more consistent work scheduleWere you terminated/discharged/laid off? NoIs this your current employer? YesMay we contact this employer at this time? YesDid you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?YesDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven Midwest and east coast regionalMiles driven weekly 2000-2500Pay Range (cents/mile) .45 &.50 cpm5Most common truck driven Tractor-TrailerMost common trailer Reefer TrailerTrailer length 53 feet or moreTennessee Transportation/Ashleys transportationCompany Tennessee Transportation/AshleystransportationContact / Supervisor NameStart Date 12-2014End Date 02-2015Address 1650 Antioch PikeCity, State/Province Zip/Postal Nashville, TNCountry United StatesPhonePosition Held Driver OTRReason for leaving? Poorly maintained equipmentWere you terminated/discharged/laid off? NoIs this your current employer? YesMay we contact this employer at this time? YesDid you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?YesDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven AllMiles driven weekly 3000-3500Pay Range (cents/mile) .43 cpmMost common truck driven Conventional TractorMost common trailer VanTrailer length 53 feet or moreTranscorp Carriers IncCompany Transcorp Carriers IncContact / Supervisor Name6Start Date 07-2014End Date 12-2014Address 2801 immanuel rdCity, State/Province Zip/Postal Greensboro, NCCountry United StatesPhone PHONE NUMBER AVAILABLEPosition Held otr driverReason for leaving? payWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?YesDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven all 48Miles driven weekly 2500-3000Pay Range (cents/mile) .32-.34Most common truck driven Conventional TractorMost common trailer Reefer TrailerTrailer length 53 feet or moreUnemploymentStart Date 05-2012End Date 06-2014Comment not really unemployed. was retired military and also worked taking care of myyoungest brother who suffered a critical fallfrom a truck and was paralyzed. i also credfor my uncle who was bed ridden and wasthe care provider for both of them. theyboth passed my brother in 2011 and myuncle 2014Clark Transfer7Company Clark TransferContact / Supervisor NameStart Date 05-2011End Date 05-2012Address 800 A Paxton StCity, State/Province Zip/Postal Harrisburg, PA 17104 Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held part time casual driverReason for leaving? care for terminally ill family members Were you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?YesDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven allMiles driven weekly 500-1000Pay Range (cents/mile) .34 cpmMost common truck driven Conventional TractorMost common trailer VanTrailer length 53 feet or moreOverbye Transport Inc.Company Overbye Transport Inc.Contact / Supervisor NameStart Date 08-2008End Date 05-2011Address 21881 Grenada AveCity, State/Province Zip/Postal Lakeville, MN 55044 8Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held owner operatorReason for leaving? retirementWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?YesDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven all 48Miles driven weekly 3500+Pay Range (cents/mile) $1.95 plus fscMost common truck driven Conventional TractorMost common trailer VanTrailer length 53 feet or moreCarroll Fulmer LogisticsCompany Carroll Fulmer LogisticsContact / Supervisor NameStart Date 02-2008End Date 07-2008Address 8340 American WayCity, State/Province Zip/Postal Groveland, FL 34736 Country United StatesPhone PHONE NUMBER AVAILABLEPosition Held owner operatorReason for leaving? company wanted part of FSCWere you terminated/discharged/laid off? NoIs this your current employer? No9May we contact this employer at this time? YesDid you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?YesDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven AllMiles driven weekly 3000-3500Pay Range (cents/mile) PercentageMost common truck driven Conventional TractorMost common trailer VanTrailer length 53 feet or moreTri State Expedited ServicesCompany Tri State Expedited ServicesContact / Supervisor NameStart Date 11-2007End Date 02-2008Address 27681 Cummings Rd.City, State/Province Zip/Postal Millbury, OH 43447 Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held expedited freight contractorReason for leaving? freight not commensurate to a solo driver Were you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?Yes10Did you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven allMiles driven weekly 1000-1500Pay Range (cents/mile) $2.50 cpm plus fscMost common truck driven Conventional TractorMost common trailer VanTrailer length 53 feet or moreUPS FreightCompany UPS FreightContact / Supervisor NameStart Date 01-2007End Date 10-2007Address 1000 SEMMES AVECity, State/Province Zip/Postal Richmond, VA 23218-1216 Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held owner operatorReason for leaving? inconsistent available freight Were you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?YesDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven allMiles driven weekly 1500-2000Pay Range (cents/mile) 1.95 cpm plus fsc11Most common truck driven Conventional TractorMost common trailer VanTrailer length 53 feet or moreNorth American Van LinesCompany North American Van LinesContact / Supervisor NameStart Date 06-1997End Date 12-2006Address 5001 Hwy 30 WCity, State/Province Zip/Postal Fort Wayne, IN 46818 Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held owner operator (Electronics Division) Reason for leaving? Contract negotiations failedWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?YesDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven allMiles driven weekly 2500-3000Pay Range (cents/mile) $1.95 plus fscMost common truck driven Conventional TractorMost common trailer LiftgateTrailer length 53 feet or more12MilitaryCountry United StatesBranch of Service Air ForceStart Date 06-1973End Date 02-1997Can you obtain your DD214? YesRank at discharge Master Srgeant/ Law Enforcement Sup FMCSRUnder FMCSR 391.15, are you currentlydisqualified from driving a commercialmotor vehicle? [49 CFR 391.15]NoHas your license, permit or privilege todrive ever been suspended or revoked forany reason? [49 CFR 391.21(b)(9)]NoHave you ever been denied a license,permit, or privilege to operate a motorvehicle?[49 CFR 391.21(b)(9)]NoWithin the past two years, have you testedpositive, or refused to test, on apre-employment drug or alcohol test by anemployer to whom you applied, but did notobtain, safety-sensitive transportation workcovered by DOT agency drug and alcoholtesting rules? [49 CFR 40.25(j)]NoIn the past three(3) years, have you everbeen convicted of any of the followingoffenses: [49 CFR 391.15]:Driving a commercial motor vehiclewith a blood alcohol concentration("BAC") of .04 percent or moreDriving under the influence ofalcohol, as prescribed by state lawRefusal to undergo drug andalcohol testing as required by anyjurisdiction for the enforcement ofFederal Motor Carrier Safety ActregulationsDriving a commercial motor vehicleunder the influence of any 21C.F.R. 1308.11 Schedule Iidentified controlled substance, anamphetamine, a narcotic drug, aformulation of an amphetamine, ora derivative of a narcotic drugNo13Transportation, possession, orunlawful use of a 21 C.F.R.1308.11 Schedule I identifiedcontrolled substance,amphetamines, narcotic drugs,formulations of an amphetamine, orderivatives of narcotic drugs whileyou were on duty driving for amotor carrierLeaving the scene of an accidentwhile operating a commercial motorvehicleOr any other felony involving theuse of a commercial motor vehicleVehicle Accident RecordWere you involved in any accidents/incidents with any vehicle in the last 3 years (even if not at fault)?Type of Accident / Incident Non-InjuryDate of Accident / Incident 06-2010Hazmat Accident / IncidentWas the vehicle towed away?CityState/Province VAWere you in a commercial vehicle? NoIf yes, was this a Department ofTransportation recordable accident?Were you at fault? NoWere you ticketed? NoDescription individual driving wrong side of roadway with lights off at night. unavoidable headon collision. other parted cited. insurancecompanies entered 3rd party albertration, iwas founf 100% Not at FaultTraffic Convictions \ ViolationsHave you had any moving violations or traffic convictions in the past 3 years? Violation Date 02-2016Charge / Description SpeedingMPH Over Limit: 15Violation State/Province IN14In Commercial Vehicle NoFined? YesLicense Suspended?License Revoked?Perform Community Service?Other Penalty?Fine Amount (if any): 100 - $199Comments:SignatureFull Name Bud Robert MoyerIP Address PHONE NUMBER AVAILABLESignature Date/Time 07-06-2024 9:46 AMBy signing my application below, I agree to use an electronic signature to demonstrate my consent. An electronic signature is as legally binding as an ink signature. This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.Signed Date: 07-06-2024 9:46 AMSigned:Federal FCRA Summary of Rights AcknowledgmentBy checking this box, I (a) acknowledgethat I have read and understand thefederal FCRA Summary of Rights andhave been given the opportunity tocopy/print the Summary of Rights and (b)agree to use an electronic signature todemonstrate my consent. An electronicsignature is as legally binding as an inksignature.YesPSP Disclosure and AuthorizationBy checking the box, I (a) acknowledge Yes15that I have read and understand the PSPDisclosure and Authorization and alsohave been given the opportunity tocopy/print it, and (b) agree to use anelectronic signature to demonstrate myconsent. An electronic signature is aslegally binding as an ink signature.FCRA DisclosureBy checking the box, I (a) acknowledgethat I have read and understand the aboveand also have been given the opportunityto copy/print it, and (b) agree to use anelectronic signature to demonstrate myconsent. An electronic signature is aslegally binding as an ink signature.YesFCRA AuthorizationBy checking the box, I (a) acknowledgethat I have read and understand the aboveand also have been given the opportunityto copy/print it, and (b) agree to use anelectronic signature to demonstrate myconsent. An electronic signature is aslegally binding as an ink signature.YesEmployment Verification Acknowledgment and Release (DOT Drug and Alcohol) By checking the box, I (a) acknowledgethat I have read and understand the aboveand also have been given the opportunityto copy/print it, and (b) agree to use anelectronic signature to demonstrate myconsent. An electronic signature is aslegally binding as an ink signature.YesSummary of Rights Under 15 U.S.C. Section 1681m(a) By checking the box, I (a) acknowledgethat I have read and understand theSummary of Rights Under 15 U.S.C.Section 1681m(a) and have been giventhe opportunity to copy/print the 1681mSummary of Rights and (b) agree to usean electronic signature to demonstrate myconsent. An electronic signature is aslegally binding as an ink signature.Yes16INVESTIGATIVE CONSUMER REPORT DISCLOSUREBy checking this box, I represent that Iunderstand and agree to the aboveInvestigative Consumer ReportDisclosure.YesUser Requested CopyUser requested a copy to be sent to thisemail address rmoyer654@gmail.com.Yes17DISCLOSURE AND AUTHORIZATION TO REQUEST INVESTIGATIVE CONSUMER REPORT & STATE SPECIFIC CONSUMER REPORTSDISCLOSUREThe Company may obtain an investigative consumer report and/or state specific consumer report ("Report") that contains background information about you from First Advantage Enterprise Screening Corporation ("First Advantage"), 1 Concourse Parkway NE Suite 200 Atlanta, GA 30328 (www.FADV.com), PHONE NUMBER AVAILABLE, for purposes of evaluating your application, appointment and/or contract terms at the time of application and throughout your affiliation with the Company.The Reports may include, but are not limited to, information regarding your character, general reputation, personal characteristics and standard of living, educational and employment history, drug/alcohol test results, OFAC/terrorist watch list, sex offender search, Social Security verification and address history, driving record and criminal record and accident history as required by the Federal Motor Carrier Safety Act, subject to any limitations imposed by applicable federal and state law. This information may be obtained through direct or indirect contact with public and private sources, including former employers, schools and public agencies or other sources. If an investigative consumer report is requested, in addition to the description above, the nature and scope of any such report will be employment verifications and references, or personal references.The specific type of report most often requested is criminal record, driving record, accident history, and employment history. You have the right to request a complete disclosure of the nature and scope of the consumer report requested and/or prepared.You also have a right to request a written summary of your rights under the FCRA from the Company. It is also available online through the Consumer Financial Protection Bureau's website: https://www.consumerfinance.gov/compliance/compliance-resources/other-applicable-requirements/fair- credit-reporting-act/model-forms-and-disclosures/AUTHORIZATIONI have carefully read the foregoing Disclosure and this Authorization. By signing below, I consent to and authorize the COMPANY to obtain from First Advantage the Reports described above. I acknowledge receipt of a copy of the "A Summary of Your Rights Under the Fair Credit Reporting Act." Printed Name:Bud Robert MoyerSocial Security #:2200Signed Date: 07-06-2024Bud Robert Moyer1225 Stoney Mountain RoadMartinsville, VA 24112PHONE NUMBER AVAILABLE18DISCLOSURE & AUTHORIZATION FOR BACKGROUND INVESTIGATION The Company will utilize the services of a third-party agency or consumer reporting agency to obtain a consumer report for purposes of evaluating your application, appointment and/or contract terms at the time of application and throughout your affiliation with the Company. The term "consumer report" includes communications by a third-party agency or consumer reporting agency bearing on your criminal background, driving record, education, prior employment, credit history, character or mode of living. Credit history will only be requested where such information is substantially related to the duties and responsibilities of the position for which you are applying or are employed in. Pursuant to the Fair Credit Reporting Act, the Company is required to obtain your permission prior to procuring the consumer report. By signing below, you hereby authorize the Company to procure report(s) on your background as described above from any third-party or consumer reporting agency contacted by the Company. You further authorize ongoing procurement of the above-mentioned report(s) at any time that you are considered for another position with the Company or at any time during your association with the Company. Printed Name:Bud Robert MoyerSocial Security #:2200Signed Date: 07-06-2024Bud Robert Moyer1225 Stoney Mountain RoadMartinsville, VA 24112PHONE NUMBER AVAILABLE19IMPORTANT DISCLOSUREREGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with Ryder Integrated Logistics, Inc. DOT#165420 ("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. AUTHORIZATIONIf you agree that the Prospective Employer may obtain such background reports, please read the following and sign below: I authorize Ryder Integrated Logistics, Inc. DOT#165420 ("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. Printed Name:Bud Robert MoyerSigned Date: 07-06-202420Request/Consent for Information from Previous Employer(s)/Carrier(s) For Alcohol and Controlled Substances Testing RecordsAnd changes in Parts 390 and 391 of the FMCSAX 07-06-2024DateX 2200Social Security NumberBud Robert Moyer1225 Stoney Mountain RoadMartinsville, VA 24112PHONE NUMBER AVAILABLEX Bud Robert MoyerPrint Name (First, MI, Last)XSignatureI, the above mentioned signer, hereby authorize Bb Trucking To release and forward in accordance with the following regulation, all known information pertaining to my alcohol and controlled substances testing/training records to Ryder Integrated Logistics, Inc. DOT#165420 DISCLOSURE |
