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Click here or scroll down to respond to this candidateRTA Logistics Inc.Street Address Country Club 24Woodridge, IL Street Address
PHONE NUMBER AVAILABLEStreet Address -14-2024 10:52:00AM CDTIntelliAppThank you for your interest in RTA Logistics Inc.. To apply for a driving position, please complete our online application for employment. Incomplete information will delay the processing of your application or prevent it from being submitted. In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.Personal InformationName Devell Edward JamersonCurrent Address 129 BreckenridgeCity, State/Province Zip/Postal Oxford, MS 38655Country United StatesResidence 3 years or longer (If No,previous addresses shown below)YesSSN/SIN 5655Date of BirthPrimary Phone PHONE NUMBER AVAILABLECell Phone PHONE NUMBER AVAILABLEEmail EMAIL AVAILABLEYes, I agree to receive informationconcerning future opportunities orpromotions from RTA Logistics Inc. byemail or other commercial electroniccommunications.YesWould you like to receive communicationfrom RTA Logistics Inc. via text message?By participating, you consent to receivetext messages sent by an automatictelephone dialing system, which maycontain recruiting/advertising messages.Consent to these terms is not a conditionof being hired, contracted, or leased. Youmay opt out at any time by texting STOP tounsubscribe. You also agree that RTALogistics Inc.'s service provider receives inreal time and logs your text messages withRTA Logistics Inc..Yes1Company QuestionsGENERAL INFORMATIONWhat position are you applying for? Company Driver If you answered "Owner Operator" or"Fleet Owner", select yes.NoEQUIPMENT (OWNER/OPERATORS ONLY)Equipment Description (Tractor):Type:Year:Make:Model:Color:VIN:WeightMileageFifth Wheel HeightWhat location are you applying for?Are you legally eligible for employment inthe United States?YesAre you currently employed? YesWhat date did your last employment end?Do you read, write, and speak English? YesHave you ever worked for this companybefore?NoEnter 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?YesEnter name: DeeHow did you hear about us? OtherIf "Driver Referral", please enter thedriver's nameIf "Other", please explain Met one of you all employees dropping of drivers.Selina Jamerson PHONE NUMBER AVAILABLE wife2Please provide your Emergency Contactinformation (Name, Number, Relationshipto you)DRIVING EXPERIENCEFor each class of equipment, select years of experience. If no experience in a class, select "None".Straight Truck NoneTractor and Semi-Trailer 9-10 yearsTractor - Two Trailers NoneOtherLicensesLicense Number 769Licensing Authority GACountry United StatesLicense ClassLicense Expiration DateDOT Medical Card Expiration DateCurrent LicenseCommercial Driver LicenseEndorsementsTanker Endorsement NoHAZMAT Endorsement NoX Endorsement NoDoubles Triples Endorsement NoOther Endorsement NoLicensesLicense Number 761Licensing Authority MSCountry USLicense Class Class ALicense Expiration Date 04-10-2026DOT Medical Card Expiration Date 08-14-2024Current License Yes3Commercial Driver License YesEndorsements NoneEmployment / UnemploymentNRGCompany NRGStart Date 07-2024End Date 08-2024AddressCity, State/Province Zip/Postal Burr Ridge, ILCountry United StatesPhonePosition HeldReason for leaving? Team driver only company I want to drive solo.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?YesDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven Midwest/WestcoastMiles driven weekly 3500+Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreOkan ExpressCompany Okan ExpressStart Date 02-20234End Date 08-2024Address 640 Pratt AveCity, State/Province Zip/Postal Schaumburg, IL 60193 Country United StatesPhone PHONE NUMBER AVAILABLEPosition Held DriveReason for leaving? Company was contracted with amazon contract ended.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?YesDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven SoutheastMiles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreQuick Transport Services IncCompany Quick Transport Services IncStart Date 01-2023End Date 01-2023AddressCity, State/Province Zip/Postal Merrillville, IN 46410 Country United StatesPhone PHONE NUMBER AVAILABLEPosition Held Solo Company DriverReason for leaving? Don't have team loads5Were 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 MidwestMiles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer Reefer TrailerTrailer length 53 feet or moreKTM UNITEDCompany KTM UNITEDStart Date 12-2022End Date 12-2022AddressCity, State/Province Zip/Postal Plaines, ILCountry United StatesPhonePosition HeldReason for leaving? No workWere 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?Yes6Did you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven MidwestMiles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreKTM UNITEDCompany KTM UNITEDStart Date 09-2021End Date 11-2022AddressCity, State/Province Zip/Postal Plaines, ILCountry United StatesPhonePosition HeldReason for leaving? Leaving Owner Operator StatusWere 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 MidwestMiles driven weeklyPay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer Van7Trailer length 53 feet or moreKtm United IncCompany Ktm United IncStart Date 09-2021End Date 09-2022Address 9002 Senta Dr #2b,City, State/Province Zip/Postal Des Plaines, IL 60016 Country United StatesPhone PHONE NUMBER AVAILABLEPosition HeldReason for leaving? Better Working ConditionsWere 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 SoutheastMiles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreIMCG (Intermodal Cartage Company)Company IMCG (Intermodal Cartage Company)Start Date 07-2021End Date 08-2021Address 5707 Holmes RDCity, State/Province Zip/Postal Memphis, TN 35677Country United States8Phone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition HeldReason for leaving? Currently employedWere 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 South East /MidwestMiles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreF2F TransportCompany F2F TransportStart Date 06-2021End Date 06-2021Address 1848 Rossville AveAddress 2 Suite 102City, State/Province Zip/Postal Chattanooga, TN 37408 Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition HeldReason for leaving? more time a homeWere you terminated/discharged/laid off? NoIs this your current employer? Yes9May 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?NoDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven 48 statesMiles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreF2F TransportPLEASE DO NOT CONTACTCompany F2F TransportStart Date 12-2020End Date 05-2021Address 1848 Rossville AveAddress 2 Suite 102City, State/Province Zip/Postal Chattanooga, TN 37408 Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition HeldReason for leaving? Still currentWere you terminated/discharged/laid off? NoIs this your current employer? YesMay we contact this employer at this time? NoDid you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyYes10Regulations while employed/contracted bythis employer/contractor?Did you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven SoutheastMiles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreBennett Drivaway (Power Only)Company Bennett Drivaway (Power Only)Start Date 05-2019End Date 11-2020Address 56960 Elk Park Dr. Elkhart INCity, State/Province Zip/Postal Elkhart, IN 56960Country United StatesPhone PHONE NUMBER AVAILABLEPosition HeldReason for leaving? Consistency and better payWere 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 48Miles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Conventional Tractor11Most common trailer VanTrailer length 53 feet or moreCircle Logistics II Inc.Company Circle Logistics II Inc.Start Date 10-2020End Date 11-2020Address 1950 Cook RdAddress 2 Suite 102City, State/Province Zip/Postal Fort Wayne, IN 46818 Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition HeldReason for leaving? Company is very unstableWere 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 Med westMiles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreCMECompany CMEStart Date 02-2020End Date 07-202012Address 5539 Torrie Park Dr.Address 2 5539 Torrie Park Dr.City, State/Province Zip/Postal Cottondale, AL 35404 Country United StatesPhone PHONE NUMBER AVAILABLEPosition HeldReason for leaving? (Up coming company) I just need better working conditionsWere 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 48Miles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer Reefer TrailerTrailer length 53 feet or moreMercer TransportationCompany Mercer TransportationStart Date 11-2019End Date 01-2020Address 1128 W MainCity, State/Province Zip/Postal Louisville, KY 40203 Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held13Reason for leaving? Not enough workWere 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 48 statesMiles driven weekly 1500-2000Pay Range (cents/mile)Most common truck driven Conventional TractorMost common trailer VanTrailer length 53 feet or moreUnemploymentStart Date 04-2019End Date 04-2019CommentRoad RunnerCompany Road RunnerStart Date 08-2018End Date 03-2019Address 4401 Bowman Industrial Ct.City, State/Province Zip/Postal Conley, GA 30288Country United StatesPhone PHONE NUMBER AVAILABLEPosition HeldReason for leaving? Better PayWere you terminated/discharged/laid off? NoIs this your current employer? NoYes14May 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 Midwest and SoutheastMiles driven weekly 2000-2500Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreGreat Wide Truck ManagementCompany Great Wide Truck ManagementStart Date 06-2018End Date 07-2018AddressCity, State/Province Zip/Postal Pittsburg, PA 15106 Country United StatesPhone PHONE NUMBER AVAILABLEPosition HeldReason for leaving? Worked for two and a half weeks and did not get paidWere 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?YesYes15Did you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?Areas Driven Southeast RegionMiles driven weekly 3000-3500Pay Range (cents/mile)Most common truck driven Conventional TractorMost common trailer VanTrailer length 53 feet or moreShelton Trucking Service, Inc.Company Shelton Trucking Service, Inc.Start Date 07-2018End Date 07-2018Address 24058 NW SR 73City, State/Province Zip/Postal Altha, FL 32421Country United StatesPhone PHONE NUMBER AVAILABLEPosition HeldReason for leaving?Were you terminated/discharged/laid off?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 DrivenMiles driven weeklyPay Range (cents/mile)Most common truck drivenMost common trailerTrailer lengthUnemploymentStart Date 12-201716End Date 05-2018Comment medical reasonsEmpire ExpressCompany Empire ExpressStart Date 10-2016End Date 12-2017Address 999 Channel AveCity, State/Province Zip/Postal Memphis, TN 38113Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition HeldReason for leaving? ResignedWere 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 southeastMiles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreHoward Sheppard, IncCompany Howard Sheppard, IncStart Date 08-2015End Date 09-2016Address 755 Waco Drive17City, State/Province Zip/Postal Sandersville, GA 31082 Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition HeldReason for leaving? RelocationWere 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 southeastMiles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer ContainerTrailer length 32 to 44 feetFedex Custom CriticalCompany Fedex Custom CriticalStart Date 04-2015End Date 08-2015Address 1475 Boettler RdCity, State/Province Zip/Postal Uniontown, OH 44685 Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition HeldReason for leaving? More stabilityWere you terminated/discharged/laid off? No18Is 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 48 statesMiles driven weekly 3000-3500Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreUnemploymentStart Date 02-2015End Date 04-2015Comment noneArcilla truckingCompany Arcilla truckingStart Date 06-2014End Date 02-2015Address 9474 highway 57City, State/Province Zip/Postal Mcintyre, GA 31054 Country United StatesPhone PHONE NUMBER AVAILABLEPosition HeldReason for leaving? Needed to work every dayWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes19vehicle?Were 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 GA Al FlMiles driven weekly 2000-2500Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer OtherTrailer length 32 to 44 feetUnemploymentStart Date 01-2014End Date 05-2014Comment job went out, closed downWestern expressCompany Western expressStart Date 12-2013End Date 01-2014Address 7135 centennial plCity, State/Province Zip/Postal Nashville, TN 37209 Country United StatesPhone PHONE NUMBER AVAILABLEPosition HeldReason for leaving? Better 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?Yes20Did you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven 48 statesMiles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreFIECompany FIEStart Date 09-2013End Date 12-2013AddressCity, State/Province Zip/Postal Macon, GA 31201Country United StatesPhone PHONE NUMBER AVAILABLEPosition HeldReason for leaving? Job relocatedWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motorvehicle?NoWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?Did you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?Areas DrivenMiles driven weeklyPay Range (cents/mile)Most common truck drivenMost common trailer21Trailer lengthCooler IceCompany Cooler IceStart Date 04-2010End Date 09-2013AddressCity, State/Province Zip/Postal Byron, GA 31008Country United StatesPhone PHONE NUMBER AVAILABLEPosition HeldReason for leaving? laid offWere you terminated/discharged/laid off? YesTermination Explanation laid offIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motorvehicle?NoWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?Did you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?Areas DrivenMiles driven weeklyPay Range (cents/mile)Most common truck drivenMost common trailerTrailer lengthUnemploymentStart Date 09-2009End Date 04-2010Comment noneBlue Bird/ For a staffing CompanyCompany Blue Bird/ For a staffing Company22Start Date 01-2008End Date 09-2009AddressCity, State/Province Zip/Postal Macon, GA 31030Country United StatesPhonePosition HeldReason for leaving? Laid offWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motorvehicle?NoWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?Did you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?Areas DrivenMiles driven weeklyPay Range (cents/mile)Most common truck drivenMost common trailerTrailer lengthTrucking SchoolStart Date 05-2001End Date 07-2001School Middle Georgia TechAddressAddress 2City, State/Province Warner Robins, GACountry United States23Phone PHONE NUMBER AVAILABLEDid you graduate? YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while attending this truckschool?YesDid you perform any safety sensitivefunctions at this truck school, regulated byDOT, and subject to drug and alcoholtesting?YesGPAHours of InstructionBorder Crossing NoLog Books YesFederal Motor Carrier Regulations YesHazardous Materials YesFMCSRUnder 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 law Refusal to undergo drug andNo24alcohol 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 drugTransportation, 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 5 years (even if not at fault)?Type of Accident / Incident Non-InjuryDate of Accident / Incident 10-2018Hazmat Accident / IncidentWas the vehicle towed away?City StanleyState/Province NCWere you in a commercial vehicle? YesIf yes, was this a Department ofTransportation recordable accident?NoWere you at fault? YesWere you ticketed? NoDescription Alleged DamageHit ParkedVehicle/Stopped VehicleMisc.PreventableAccident/Incident25Traffic Convictions \ ViolationsHave you had any moving violations or traffic convictions in the past 3 years? No ViolationsCriminal RecordHave you ever been convicted of a crime? NoDo you have any deferred prosecutions? NoDo you have criminal charges pending? NoHave you ever pled "guilty" to, beenconvicted of, or pled "no contest" to afelony?NoIf you have any felony convictions, do youcurrently hold a minister's permit to enteror exit Canada?NoHave you, within the last five years, pled"guilty" to, been convicted of, hadprosecution deferred in connection with, orpled "no contest" to a misdemeanor?NoSignatureFull Name Devell Edward JamersonIP Address 2600:1008:b077:12ec:7c50:d9ec:c56a:bcae Signature Date/Time 08-14-2024 10:52 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: 08-14-2024 10:52 AMSigned:Federal FCRA Summary of Rights AcknowledgmentBy checking this box, I (a) acknowledge Yes26that 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.PSP Disclosure and AuthorizationBy checking the box, I (a) acknowledgethat I have read and understand the PSPDisclosure and Authorization and alsohave been given the |
