| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidatePersonal InformationName Candidate's Name
Current Address Street Address Longmeadow DrCity, State/Province Zip/Postal Sissonville, WV Street Address
Country United StatesResidence 3 years or longer (If No, Yes previous addresses shown below)SSN/SIN 8965Date of BirthPrimary Phone PHONE NUMBER AVAILABLEPreferred method of contact Primary PhoneBest time to contact you AnyEmail EMAIL AVAILABLEYes, I agree to receive information concerning future opportunities or promotions from Merdzic Transportation Services, Inc. by email or other commercial electronic communications.YesWould you like to receive communication from Merdzic Transportation Services, Inc. via text message?By participating, you consent to receive text messages sent by an automatic telephone dialing system, which may contain recruiting/advertising messages. Consent to these terms is not a condition of being hired, contracted, or leased. You may opt out at any time by texting STOP to unsubscribe. You also agree that Merdzic Transportation Services, Inc.'s serviceYes1provider receives in real time and logs your text messages with Merdzic Transportation Services, Inc..Company QuestionsGENERAL INFORMATIONDesired weekly miles? 2500+Desired take home pay? 2000Desired home time? 10-11 days out, 2-3 days offDo you have experience using the Motive(formerly KeepTruckin') Electronic Logbook App?NoAre you applying for an Owner Operator No position?TypeYearMakeModelColorVinWeightMileageDo you have your own trailer'? NoTypeYearMakeColorVINWeightPlease select an option for your trailer I am a company driver and will use company issued trailerAre you applying for a company driver Yes position?This is a W2 position. Are you ok with Yes that?Are you applying for a Lease Purchase No position?2You will need to provide your own transportation to our terminal. Are you ok with that?YesWhat date can you start? 10-07-2024Are you legally eligible for employment in Yes the United States?Are you currently employed? YesWhat date did your last employment end?Do you read, write, and speak English? YesHave you ever worked for this company No before?Enter start and end dates, location, position, and reason for leaving:Do you have a TWIC card? NoExpiration Date:Please enter the names of any relatives employed here:Have you ever been known by any other No name?Enter name:How did you hear about us?If "Driver Referral", please enter the driver's nameIf "Other", please explainIn case of Emergency, notify (list name, address, and phone):Straight Truck 7 yrsTractor and Semi - Trailer 18 yrsTractor - Two Trailers Less then 6 monthsOtherList states/regions operated in for the past 5 years:Which safe driving awards do you hold and from whom?EDUCATIONList highest grade completed: Grade 12List last school attended (name, city, and Sissonville High School Sissonville WV state):PERSONAL REFERENCES3List name, address, city, state, phone number, and relationship:First Reference:Second Reference:Third Reference:LicensesLicense Number 330Licensing Authority WVCountry USLicense Class Class ALicense Expiration Date 02-16-2028DOT Medical Card Expiration Date 03-20-2024Current License YesCommercial Driver License YesEndorsementsTanker Endorsement YesHAZMAT Endorsement YesX Endorsement NoDoubles Triples Endorsement YesOther Endorsement NoLicensesLicense Number 543Licensing Authority INCountry USLicense Class Class ALicense Expiration Date 07-07-2020DOT Medical Card Expiration Date 01-07-2013Current License NoCommercial Driver License YesEndorsementsTanker Endorsement NoHAZMAT Endorsement NoX Endorsement No4Doubles Triples Endorsement YesOther Endorsement NoEmployment / UnemploymentOsborne Trucking Co.Company Osborne Trucking Co.Start Date 07-2024End Date 09-2024Address 325 Osborne Dr.City, State/Province Zip/Postal Fairfield, OH 45014Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held DriverReason for leaving? Want to be localWere you terminated/discharged/laid off? NoIs this your current employer? YesMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven RegionalMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) Flat rate per dayMost common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreGMBCompany GMB5Start Date 02-2024End Date 07-2024Address 108 Wood StCity, State/Province Zip/Postal Flushing, OHCountry United StatesPhone PHONE NUMBER AVAILABLEPosition Held DriverReason for leaving? Not stableWere you terminated/discharged/laid off? NoIs this your current employer? YesMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven LocalMiles driven weekly 1,000 - 2,000Pay Range (cents/mile) Per hourMost common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreCrete Carrier CorporationCompany Crete Carrier CorporationStart Date 12-2023End Date 01-2024Address 400 Northwest 56th StCity, State/Province Zip/Postal Lincoln, NE 68528Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held Driver6Reason for leaving? Want to be home moreWere you terminated/discharged/laid off? NoIs this your current employer? YesMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven 48 statesMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) .63Most common truck driven Conventional TractorMost common trailer Reefer TrailerTrailer length 53 feet or moreCardinal Logistics Management Corp.Company Cardinal Logistics Management Corp.Start Date 07-2023End Date 11-2023Address 5333 Davidson HighwayCity, State/Province Zip/Postal Concord, NC 28027Country United StatesPhone PHONE NUMBER AVAILABLEPosition Held DriverReason for leaving? Want to be home moreWere you terminated/discharged/laid off? NoIs this your current employer? YesMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada SafetyYes7Regulations while employed/contracted by this employer/contractor?Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven RegionalMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) .70Most common truck driven Conventional TractorMost common trailer VanTrailer length 53 feet or moreB&L TransportCompany B&L TransportStart Date 07-2023End Date 07-2023Address 1760 S. Washington StCity, State/Province Zip/Postal Millersburg, OH 44654Country United StatesPhone PHONE NUMBER AVAILABLEPosition Held DriverReason for leaving? Can't do the 3 to 4 weeks out to hard on familyWere you terminated/discharged/laid off? NoIs this your current employer? YesMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven East coast mainlyMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) Cpm8Most common truck driven Tractor-TrailerMost common trailer Reefer TrailerTrailer length 53 feet or more10 Roads Express, LLCCompany 10 Roads Express, LLCStart Date 05-2023End Date 06-2023Address 2200 Abbott DriveCity, State/Province Zip/Postal Carter Lake, IA 51510Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held DriverReason for leaving? Lost my routeWere you terminated/discharged/laid off? YesTermination Explanation Laid offIs this your current employer? YesMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven 3 statesMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) Per hourMost common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreLEL Logistics LLCCompany LEL Logistics LLCStart Date 11-20209End Date 05-2023Address 4501 Navarre Rd SWCity, State/Province Zip/Postal Canton, OHCountry United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held DriverReason for leaving? Not stable workWere you terminated/discharged/laid off? NoIs this your current employer? YesMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven Ohio West Virginia and to North CarolinaMiles driven weekly 1,000 - 2,000Pay Range (cents/mile) Per hourMost common truck driven Day CabMost common trailer Reefer TrailerTrailer length 53 feet or moreSmith TransportCompany Smith TransportStart Date 06-2020End Date 10-2020Address 331 E CLOSSON RDCity, State/Province Zip/Postal Roaring Spring, PA 16673Country United StatesPhone PHONE NUMBER AVAILABLEPosition Held DriverReason for leaving? Can seem to get my money right10Were you terminated/discharged/laid off? NoIs this your current employer? YesMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven East coastMiles driven weekly 1,000 - 2,000Pay Range (cents/mile) Per mileMost common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreJohn Christner TruckingCompany John Christner TruckingStart Date 05-2020End Date 06-2020Address 19007 W HIGHWAY 33City, State/Province Zip/Postal Sapulpa, OK 74066Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held DriverReason for leaving? Not getting me homeWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada SafetyYes11Regulations while employed/contracted by this employer/contractor?Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven 48 statesMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) Lease purchaseMost common truck driven Tractor-TrailerMost common trailer Reefer TrailerTrailer length 53 feet or moreB&L TransportCompany B&L TransportStart Date 11-2018End Date 05-2020AddressCity, State/Province Zip/Postal Millersburg, OHCountry United StatesPhonePosition HeldReason for leaving? I thought I could make what I need being localWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven East coastMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) Per mile12Most common truck driven Tractor-TrailerMost common trailer Reefer TrailerTrailer length 53 feet or moreJ B Hunt Transport, Inc.Company J B Hunt Transport, Inc.Start Date 04-2017End Date 10-2018Address 1510 e 4th streetCity, State/Province Zip/Postal Lowell, ARCountry United StatesPhonePosition Held DriverReason for leaving? Thought I was going to have more money and hometimeWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven East coastMiles driven weekly 1,000 - 2,000Pay Range (cents/mile) CpmMost common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreJ B HuntCompany J B HuntStart Date 01-2013End Date 03-201713Address 1510 east 4th streetCity, State/Province Zip/Postal Seymour, IN 47274Country United StatesPhone PHONE NUMBER AVAILABLEPosition Held driverReason for leaving? need to make some more money not possible hereWere you terminated/discharged/laid off? NoIs this your current employer? YesMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven East coastMiles driven weekly 1,000 - 2,000Pay Range (cents/mile) CpmMost common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreBaylor TruckingCompany Baylor TruckingStart Date 08-2012End Date 01-2013Address 5114 N SR 101City, State/Province Zip/Postal Milan, IN 47031Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held driverReason for leaving? wanted to be home more14Were you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven East coastMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) Per mileMost common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreFreymiller Inc.Company Freymiller Inc.Start Date 06-2012End Date 08-2012Address 8125 SW 15th StreetCity, State/Province Zip/Postal Oklahoma City, OK 73128Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held driverReason for leaving? out to much and not enough milesWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada SafetyYes15Regulations while employed/contracted by this employer/contractor?Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven 48 statesMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) CpmMost common truck driven Conventional TractorMost common trailer Reefer TrailerTrailer length 53 feet or moreBaylor TruckingCompany Baylor TruckingStart Date 11-2011End Date 06-2012Address 5114 N SR 101City, State/Province Zip/Postal Milan, IN 47031Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held driverReason for leaving? wanted to be moreWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven East coastMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) Cpm16Most common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreElliott Transport Systems IncCompany Elliott Transport Systems IncStart Date 09-2011End Date 11-2011Address 4101 32nd Avenue SouthCity, State/Province Zip/Postal Moorhead, MN 56560Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held driverReason for leaving? not enough moneyWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven East coastMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) PercentageMost common truck driven Tractor-TrailerMost common trailer Reefer TrailerTrailer length 53 feet or moreBaylor TruckingCompany Baylor TruckingStart Date 03-2011End Date 09-201117Address 5114 N SR 101City, State/Province Zip/Postal Milan, IN 47031Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held driverReason for leaving? not enough moneyWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven East coastMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) CpmMost common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreO&S TruckingCompany O&S TruckingStart Date 01-2011End Date 02-2011Address 3769 E. EvergreenCity, State/Province Zip/Postal Springfield, MO 65803Country United StatesPhone PHONE NUMBER AVAILABLEPosition Held lease purchaseReason for leaving? no moneyWere you terminated/discharged/laid off? No18Is this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven East of the MississippiMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) Lease purchaseMost common truck driven Tractor-TrailerMost common trailer Reefer TrailerTrailer length 53 feet or moreMedford TruckingCompany Medford TruckingStart Date 11-2009End Date 01-2011Address 4798 Kanawha Blvd ECity, State/Province Zip/Postal Charleston, WV 25306Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held driverReason for leaving? not enogh moneyWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?Yes19Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven LocalMiles driven weekly 1,000 - 2,000Pay Range (cents/mile) PercentageMost common truck driven Day CabMost common trailer OtherTrailer length 32 to 44 feetArrow TruckingCompany Arrow TruckingStart Date 09-2009End Date 10-2009Address 4230 Elwood DrCity, State/Province Zip/Postal Tulsa, OK 74101Country United StatesPhonePosition Held driverReason for leaving? out of businessWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven East coastMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) CpmMost common truck driven Tractor-TrailerMost common trailer Flatbed20Trailer length 45 to 52 feetMelton Truck LinesCompany Melton Truck LinesStart Date 09-2008End Date 03-2009Address 808 N 161st East AveCity, State/Province Zip/Postal Tulsa, OK 74116Country United StatesPhone PHONE NUMBER AVAILABLEPosition Held driverReason for leaving? not enough moneyWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven East to MidwestMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) CpmMost common truck driven Tractor-TrailerMost common trailer FlatbedTrailer length 45 to 52 feetKnight TransportationCompany Knight TransportationStart Date 04-2008End Date 08-2008Address 20002 N 19th Ave.City, State/Province Zip/Postal Phoenix, AZ 85027Country United States21Phone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held driverReason for leaving? not enough moneyWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven East coastMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) CpmMost common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreStoughton Trucking IncCompany Stoughton Trucking IncStart Date 06-2007End Date 04-2008Address 1901 Academy StCity, State/Province Zip/Postal Stoughton, WI 53589Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held driverReason for leaving? not enough home timeWere you terminated/discharged/laid off? NoIs this your current employer? NoYes22May we contact this employer at this time?Did you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing?YesAreas Driven East coastMiles driven weekly 2,000 - 3,000Pay Range (cents/mile) CpmMost common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreS & T PipelineCompany S & T PipelineStart Date 08-2006End Date 06-2007AddressCity, State/Province Zip/Postal Clendenin, WVCountry United StatesPhonePosition Held driverReason for leaving? seasonalWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motor Yes vehicle?Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor?YesDid you perform any safety sensitive functions in this job, regulated by DOT,Yes23and subject to drug and alcohol testing?Areas Driven LocalMiles driven weekly 1,000 - 2,000Pay Range (cents/mile) HourlyMost common truck driven Day CabMost common trailer FlatbedTrailer length 45 to 52 feetFMCSRUnder FMCSR 391.15, are you currently disqualified from driving a commercial motor vehicle? [49 CFR 391.15]NoHas your license, permit or privilege to drive ever been suspended or revoked for any reason? [49 CFR 391.21(b)(9)]NoHave you ever been denied a license, permit, or privilege to operate a motor vehicle?[49 CFR 391.21(b)(9)]NoWithin the past two years, have you tested positive, or refused to test, on a pre-employment drug or alcohol test by an employer to whom you applied, but did not obtain, safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules? [49 CFR 40.25(j)]NoIn the past three(3) years, have you ever been convicted of any of the following offenses: [49 CFR 391.15]: Driving a commercial motor vehicle with a blood alcohol concentration ("BAC") of .04 percent or more Driving under the influence of alcohol, as prescribed by state law Refusal to undergo drug and alcohol testing as required by any jurisdiction for the enforcement of Federal Motor Carrier Safety Act regulations Driving a commercial motor vehicle under the influence of any 21 C.F.R. 1308.11 Schedule I identified controlled substance, an amphetamine, a narcotic drug, a formulation of an amphetamine, or a derivative of a narcotic drugNo24 Transportation, possession, or unlawful use of a 21 C.F.R. 1308.11 Schedule I identified controlled substance, amphetamines, narcotic drugs, formulations of an amphetamine, or derivatives of narcotic drugs while you were on duty driving for a motor carrier Leaving the scene of an accident while operating a commercial motor vehicle Or any other felony involving the use 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)?No AccidentsTraffic 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? YesComment12 /2001 did no jail time just probation and paid insurance company back My charge was insurance fraud and it is a felonyDo you have any deferred prosecutions? NoDo you have criminal charges pending? NoHave you ever pled "guilty" to, been convicted of, or pled "no contest" to a felony?YesComment Same as above only thing on meIf you have any felony convictions, do you currently hold a minister's permit to enter or exit Canada?NoHave you, within the last five years, pled "guilty" to, been convicted of, had prosecution deferred in connection with, orNo25pled "no contest" to a misdemeanor?SignatureFull Name Candidate's Name
IP Address 2600:387:15:3216:8Signature Date/Time 09-18-2024 11:30 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:Signed |
