Application For Driver PDF Details

Embarking on a journey to secure employment as a driver entails navigating through numerous regulatory requirements, one of which is the completion of the Application For Driver form. This document, while not mandated to follow a universal format, needs to encapsulate specific information as outlined in 49 CFR 391.21 to be considered valid for potential employers—typically freight carriers. At its core, the form serves as a comprehensive dossier of an applicant, featuring personal details, legal eligibility to work in the United States, license information adhering to the stipulation that no commercial driver may possess more than one driver's license, and a thorough account of both driving and employment histories. Additionally, this application mandates disclosures relating to any accidents within the last three years, including incidents, chemical spills, fatalities, and injuries, as well as all traffic convictions and forfeitures, with the exception of parking violations, during the same timeframe. Prospective employers are granted the authority by applicants through this form to conduct in-depth investigations into the latter's personal, employment, financial, and medical backgrounds, thereby ensuring that all claims and records are meticulously verified. This verification process is pivotal, as any discrepancies can lead to the disqualification of the candidate or dismissal if inconsistencies are discovered after employment has commenced. Furthermore, it touches upon the Federal Motor Carrier Safety Regulations, highlighting the necessity for disclosing positions governed by these rules in the past and signaling if any job was designated as safety-sensitive, hence subject to rigorous alcohol and controlled substances testing as required by 49 CFR, part 40. In essence, this form doesn't merely collect data—it lays the groundwork for a transparent and accountable relationship between drivers and their potential or future employers in the logistics and transportation industry.

QuestionAnswer
Form NameApplication For Driver
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namespdf fillable driver application, employment application, commercial driver application form, cdl application form

Form Preview Example

This is an example driver employment application. Carriers do not need to use this exact form, but must have a completed and signed employment application for all drivers that contains the information listed in 49 CFR 391.21.

DRIVER EMPLOYMENTAPPLICATION

[COMPANY NAME, ADDRESS, PHONE NUMBER, AND EMAIL]

An Equal Opportunity Employer

COMPLETE IN FULL OR IT WILL NOT BE CONSIDERED.

 

 

 

 

APPLICANT INFORMATION

 

 

 

 

 

 

 

 

 

 

MIDDLE

 

 

 

LAST

 

 

 

 

 

FIRST NAME

 

 

NAME

 

 

 

NAME

 

 

 

 

 

PHONE

 

 

EMAIL

 

 

 

 

 

 

 

 

 

DATE OF BIRTH

 

 

SOCIAL SECURITY #

 

 

 

 

 

 

 

 

DATE OF

 

POSITION

 

 

 

 

 

DATE AVAILABLE

 

 

 

APPLICATION

 

APPLIED FOR

 

 

 

 

 

FOR WORK

 

 

 

Do you have legal right to work in the United States?

☐ YES ☐ NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PREVIOUS THREE YEARS RESIDENCY

 

 

 

 

 

 

 

 

 

Attach additional sheet if more space is needed

 

 

 

 

 

 

 

 

 

 

 

 

 

ZIP

# OF YEARS

 

STREET

 

 

 

 

CITY

 

 

STATE

 

CODE

AT ADDRESS

CURRENT

 

 

 

 

 

 

 

 

 

 

 

 

 

MAILING

 

 

 

 

 

 

 

 

 

 

 

 

 

PREVIOUS

 

 

 

 

 

 

 

 

 

 

 

 

 

PREVIOUS

 

 

 

 

 

 

 

 

 

 

 

 

 

PREVIOUS

 

 

 

 

 

 

 

 

 

 

 

 

 

LICENSE INFORMATION

No person who operates a commercial motor vehicle shall at any time have more than one driver’s license (49 CFR 383.21). I certify that I do not have more than one motor vehicle license, the information for which is listed below. Include all licenses held for the past 3 years; attach additional sheets if needed.

STATE

LICENSE #

TYPE/CLASS

ENDORSEMENTS

EXPIRATION DATE

PREVOIUSLY HELD LICENSES

DRIVING EXPERIENCE

CLASS OF

 

TYPE OF EQUIPMENT (VAN, TANK, FLAT, ETC.)

 

DATE FROM

 

DATE TO

APPROX # OF

EQUIPMENT

 

 

 

MILES (TOTAL)

STRAIGHT

 

 

 

 

 

 

 

TRUCK

 

 

 

 

 

 

 

TRACTOR &

 

 

 

 

 

 

 

SEMI-TRAILER

 

 

 

 

 

 

 

TRACTOR &

 

 

 

 

 

 

 

2 TRAILERS

 

 

 

 

 

 

 

TRACTOR &

 

 

 

 

 

 

 

TANKER

 

 

 

 

 

 

 

OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Page 1 of 4

ACCIDENT RECORD FOR THE PAST 3 YEARS

Attach additional sheet if more space is needed. Check this box if none

DATES (List most recent first)

NATURE OF ACCIDENT (Head-on, rear-end, upset, etc.)

CHEMICAL SPILLS

# FATALITIES # INJURIES (Y/N)

TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS (OTHER THAN PARKING VIOLATIONS)

Attach additional sheet if more space is needed. Check this box if none

DATE CONVICTED (Month/Year)

VIOLATION

STATE OF

VIOLATION PENALTY (Forfeited bond, collateral and/or points)

Have you ever been denied a license, permit, or privilege to operate a motor vehicle?

☐ YES

☐ NO

If yes, explain

 

 

Has any license, permit, or privilege ever been suspended or revoked?

☐ YES

☐ NO

If yes, explain

 

 

EMPLOYMENT HISTORYZ

The Federal Motor Carrier Safety Regulations (49 CFR 391.21) require that all applicants wishing to drive a commercial vehicle list all employment for the last three (3) years. In addition, if you have driven a commercial vehicle previously, you must provide employment history for an additional seven (7) years (for a total of ten (10) years). Any gaps in employment in excess of one (1) month must be explained.

Start with the last or current position, including any military experience, and work backwards (attach separate sheets if necessary). You are required to list the complete mailing address, including street number, city, state, zip; and complete all other information.

CURRENT (MOST RECENT) EMPLOYER

 

 

 

 

 

 

NAME

 

 

 

 

 

PHONE

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

FROM

 

 

 

TO

 

POSITION HELD

 

 

MO/YR

 

 

 

MO/YR

 

REASON FOR LEAVING

 

 

 

 

 

SALARY

 

EXPLAIN ANY GAPS IN

 

 

 

 

 

 

 

EMPLOYMENT (Include

 

 

 

 

 

 

 

month/year & reason)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Page 2 of 4

While employed here, were you subject to the Federal Motor Carrier Safety Regulations?

 

 

 

 

☐ YES

☐ NO

 

Was the job designated as a safety-sensitive function in any Department of Transportation-regulated

 

 

 

 

 

 

mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?

 

 

 

 

☐ YES

☐ NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECOND (MOST RECENT) EMPLOYER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME

 

 

 

 

 

 

 

 

PHONE

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FROM

 

 

TO

 

 

 

 

 

 

POSITION HELD

 

 

 

 

MO/YR

 

 

MO/YR

 

 

 

 

 

 

REASON FOR LEAVING

 

 

 

 

 

 

 

SALARY

 

 

 

 

 

EXPLAIN ANY GAPS IN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYMENT (Include

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

month/year & reason)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

While employed here, were you subject to the Federal Motor Carrier Safety Regulations?

 

 

 

 

☐ YES

☐ NO

Was the job designated as a safety-sensitive function in any Department of Transportation-regulated

 

 

 

 

 

 

mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?

 

 

 

 

☐ YES

☐ NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THIRD (MOST RECENT) EMPLOYER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME

 

 

 

 

 

 

 

 

PHONE

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FROM

 

 

TO

 

 

 

 

 

 

POSITION HELD

 

 

 

 

MO/YR

 

 

MO/YR

 

 

 

 

 

 

REASON FOR LEAVING

 

 

 

 

 

 

 

SALARY

 

 

 

 

 

EXPLAIN ANY GAPS IN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYMENT (Include

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

month/year & reason)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

While employed here, were you subject to the Federal Motor Carrier Safety Regulations?

 

 

 

 

☐ YES

☐ NO

 

Was the job designated as a safety-sensitive function in any Department of Transportation-regulated

 

 

 

 

 

 

mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?

 

 

 

 

☐ YES

☐ NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EDUCATION

 

 

 

 

 

 

 

 

 

SCHOOL

 

NAME & LOCATION

 

 

COURSE OF STUDY

YEARS

GRADUATE

DETAILS

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPLETED

Y

N

 

 

 

 

High School

 

 

 

 

 

 

 

 

 

 

 

 

 

College

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER QUALIFICATIONS

Please list any other qualifications that you have and which you believe should be considered.

Page 3 of 4

TO BE READ AND SIGNED BY APPLICANT

I authorize you to make investigations (including contacting current and prior employers) into my personal, employment, financial, medical history, and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, health care providers, and other persons from all liability in responding to inquiries and releasing information in connection with my application.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the Company.

I understand that the information I provide regarding my current and/or prior employers may be used, and those employer(s) will be contacted for the purpose of investigating my safety performance history as required by 49 CFR 391.23. I understand that I have the right to:

Review information provided by current/previous employers;

Have errors in the information corrected by previous employers, and for those previous employers to resend the corrected information to the prospective employer; and

Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge. Note: A motor carrier may require an applicant to provide more information than that required by the Federal Motor Carrier Safety Regulations.

Applicant Signature

Applicant Name (printed)

Date

Page 4 of 4

How to Edit Application For Driver Online for Free

The PDF editor was made with the intention of making it as effortless and easy-to-use as possible. The following actions will help make filling up the driver application form template simple.

Step 1: You can select the orange "Get Form Now" button at the top of this page.

Step 2: As soon as you have entered the driver application form template edit page, you'll discover all actions it is possible to take concerning your file at the top menu.

The PDF template you desire to complete will consist of the following areas:

portion of spaces in trucking application

In the PREVIOUS, PREVIOUS, LICENSE INFORMATION, No person who operates a, STATE, LICENSE, TYPECLASS, ENDORSEMENTS, EXPIRATION DATE, PREVOIUSLY HELD LICENSES, DRIVING EXPERIENCE, TYPE OF EQUIPMENT VAN TANK FLAT ETC, DATE FROM, DATE TO, and APPROX OF MILES TOTAL field, jot down your details.

PREVIOUS, PREVIOUS, LICENSE INFORMATION, No person who operates a, STATE, LICENSE, TYPECLASS, ENDORSEMENTS, EXPIRATION DATE, PREVOIUSLY HELD LICENSES, DRIVING EXPERIENCE, TYPE OF EQUIPMENT VAN TANK FLAT ETC, DATE FROM, DATE TO, and APPROX  OF MILES TOTAL in trucking application

You should provide the required information within the TRACTOR TANKER, OTHER, and Page of area.

part 3 to entering details in trucking application

The space ACCIDENT RECORD FOR THE PAST YEARS, Attach additional sheet if more, DATES List most recent first, NATURE OF ACCIDENT Headon rearend, FATALITIES INJURIES, CHEMICAL SPILLS YN, TRAFFIC CONVICTIONS AND, DATE CONVICTED MonthYear, VIOLATION, STATE OF VIOLATION, and PENALTY Forfeited bond collateral will be where you can indicate all parties' rights and obligations.

part 4 to completing trucking application

Finalize by taking a look at the following sections and completing them accordingly: Have you ever been denied a, YES NO, If yes explain, Has any license permit or, YES NO, If yes explain, EMPLOYMENT HISTORYZ The Federal, Start with the last or current, CURRENT MOST RECENT EMPLOYER, NAME, ADDRESS, and PHONE.

trucking application Have you ever been denied a, YES  NO, If yes explain, Has any license permit or, YES  NO, If yes explain, EMPLOYMENT HISTORYZ The Federal, Start with the last or current, CURRENT MOST RECENT EMPLOYER, NAME, ADDRESS, and PHONE blanks to insert

Step 3: Hit the "Done" button. It's now possible to upload the PDF form to your electronic device. Besides, you can easily send it through electronic mail.

Step 4: Produce duplicates of the template. This will save you from potential concerns. We do not check or reveal the information you have, as a consequence be assured it is safe.

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