The Driving Record Filler form serves as a critical tool in the domain of commercial driving, embodying a bridge between regulatory compliance and the monitoring of a driver's roadway behavior across the United States. At its core, this annually mandated document requires commercial drivers to furnish a comprehensive list of all motor vehicle traffic law violations, except parking offenses, over the preceding twelve months, thereby reinforcing a culture of accountability and safety. This directive, as outlined by Section 391.27 of the Federal Motor Carrier Safety Regulations, not only facilitates a transparent communication channel between drivers and motor carriers but also exempts reporting of offenses already covered under Section 383.31, avoiding redundancy. The form explicitly prompts drivers to disclose their identification details, employment history, the nature of any traffic violations incurred, and if no violations have occurred, to assert the same. This process culminates in a certification that the information provided is both complete and accurate to the best of the driver's knowledge. However, the responsibility doesn’t end with the driver. On the other side, motor carriers are tasked with the annual review of these submissions in accordance with Section 391.25, evaluating each driver’s eligibility for continued employment based on their adherence to safe driving standards. This segment involves a critical evaulation, determining whether a driver meets the minimum requirements for safe operation, is disqualified, or falls below satisfactory safe driving performance, thereby guiding necessary administrative actions. The synergy between driver self-reporting and carrier review encapsulated in the Driving Record Filler form underscores its quintessential role in promoting road safety and compliance with federal regulations.
| Question | Answer |
|---|---|
| Form Name | Driving Record Filler Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | diesel record fill, record filler form, driving filler, record filler |
MOTOR VECHICLE DRIVER’S CERTIFICATION OF VIOLATIONS/ANNUAL REVIEW OF DRIVING RECORD
MOTOR CARRIER INSTRUCTIONS: Each motor carrier shall at least once every 12 months, require each driver it employs to prepare and furnish it with a list of all violations of motor vehicle traffic laws and ordinances (other than violations involving only parking) of which the driver has been convicted, or on account of which he/she has forfeited bond or collateral during the preceding 12 months (Section 391.27). Drivers who have provided information required by Section 383.31 need not repeat that information on this form.
DRIVER REQUIREMENTS: Each driver shall furnish the list as required by the motor carrier above. If the driver has not been convicted of, or forfeited bond or collateral on account of any violation which must be listed, he/she shall so certify (Section 391.27).
COMPLETED BY DRIVER – CERTIFICATION OF VIOLATIONS
NAME OF DRIVER: (PRINT) |
SOCIAL SECURITY NUMBER |
DATE OF EMPLOYMENT |
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HOME TERMINAL (CITY AND STATE) |
DRIVER’S LICENSE NUMBER / STATE |
EXPIRATION DATE |
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I certify that the following is a true and complete list of traffic violations required to be listed (other than those I have provided under Part 383) for which I have been convicted or forfeited bond or collateral during the past 12 months.
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(If you have had no violations, check the following box - None.) |
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DATE |
OFFENSE |
LOCATION |
TYPE OF VEHICLE OPERATED |
________________ |
______________________ |
_________________________ __________________________ |
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________________ |
______________________ |
_________________________ __________________________ |
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________________ _______________________ |
_________________________ __________________________ |
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________________ _______________________ |
_________________________ _________________________ |
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________________ _______________________ |
_________________________ |
_________________________ |
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If no violations are listed above, I certify that I have not been convicted or forfeited bond or collateral on account of any violation (other than those I have provided under Part 383) required to be listed during the past 12 months.
(Today’s Date)
Date of Certification ____________________ Driver’s Signature _____________________________________
COMPLETED BY MOTOR CARRIER – ANNUAL REVIEW OF DRIVING RECORD
MOTOR CARRIER INSTRUCTIONS: Review the Certification of Violations listed above and other information described in Section 391.25 of the Federal Motor Carrier Safety Regulations. Complete the information requested below.
I have hereby reviewed the driving record of the above named driver in accordance with Section 391.25 and find that he/she (check one):
Meets minimum requirements for safe drivingIs disqualified to drive a motor vehicle pursuant to Section 391.15 Does not adequately meet satisfactory safe driving performance
Action taken with driver: _______________________________________________________________________________________
___________________________________________________________________________________________________________
Reviewed by:______________________________________________________________ Date____________________________
Signature
__________________________________________________________
Printed Name
Ace Doran Hauling & Rigging, 1601 BLUE ROCK STREET, CINCINNATI, OHIO 45223