Inf 1100 Form PDF Details

In today’s fast-paced world, ensuring the safety and compliance of commercial driving operations is more crucial than ever. Enter the INF 1100 form, a vital tool administered by the Department of Motor Vehicles Information Services Branch, aimed at enhancing public safety on the roads. This form serves as a gateway for employers to participate in the Employer Pull Notice (EPN) program, which mandates the continuous monitoring of drivers' records to ensure their eligibility and safety status. By either enrolling or deleting drivers from their monitoring list, businesses are actively contributing to a safer driving environment. The form requires detailed information, including employer's current address, contact person’s details, and specific driver license classifications. Additionally, it entails an agreement – endorsed through a declaration under penalty of perjury under Californian law – verifying the accuracy of the information provided and the legitimate enrollment or deletion request of drivers. This mechanism not only facilitates a structured way to maintain or discontinue oversight on drivers but also underscores the legal responsibilities of employers in safeguarding public welfare through diligent monitoring. Moreover, the Inf 1100 form includes provisions for adding remarks and processing fees, reflecting its comprehensive approach to driver management. As a linchpin in the pursuit of safer commercial driving operations, the Inf 1100 form reflects the intertwining of legal compliance and public safety, proving indispensable for employers within California’s dynamic transportation landscape.

QuestionAnswer
Form NameInf 1100 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other nameschassis inspection form, inf 1100, inf 1100 form, inf 1100 pull notice

Form Preview Example

 

COMMERCIAL EMPLOYER PULL NOTICE

A Public Service Agency

ENROLLMENT OR DELETION OF DRIVERS

 

 

 

 

 

 

 

 

 

 

CHECK ONLY ONE PROCESS PER FORM

 

 

 

ENROLL OR

DELETE

 

Please type or print in ink

Department of Motor Vehicles

Information Services Branch

Employer Pull Notice—H265

P.O. Box 944231

Sacramento, CA 94244-2310

EMPLOYER

CURRENT ADDRESS

CITY

STATE

ZIP CODE

 

REQUESTER CODE

DATE

 

 

TELEPHONE

 

(

)

Ext

CONTACT PERSON’S NAME AND TITLE (FIRST, MI, LAST)

 

 

 

 

CLASS LICENSE

 

A - Class A

B/P - Class B with passengers (Charter-Party)

C/S - Class C with Special Certiicates

B - Class B

C/H - Class C with Hazardous Materials Endorsement

C/P - Class C with PUC permit issued

 

 

 

 

 

 

CALIFORNIA DRIVER LICENSE OR

DRIVER’S

CLASS

 

“REMARKS” FOR YOUR USE

 

TEMPORARY “X” NUMBER

LAST NAME ONLY

LICENSE

 

(LIMIT TO 21 SPACES)

 

 

 

 

 

 

 

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TOTAL DRIVERS ADDED (A $5 ENROLLMENT FEE FOR EACH DRIVER WILL BE BILLED TO YOUR ABIS ACCOUNT)

TOTAL DRIVERS DELETED (NO FEE)

FOR ENROLLMENT ONLY:

I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

The driver(s) listed above are (1) mandated for enrollment under California Vehicle Code §1808.1. OR (2) have signed an“Authorization for Release of driver Record Information” form (INF 1101) or internal document with similar language AND are currently in an employer/ employee relationship AND frequently drive during the course of their employment.

DATE

SIgNATURE

X

PRINTED NAME AND TITLE

To obtain additional forms and information please visit our website at: http://www.dmv.ca.gov/vehindustry/epn/epngeninfo.htm

INF 1100 (REV. 2/2010) WWW

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Simple tips to prepare inf 1100 rev 8 2018 step 1

2. Once your current task is complete, take the next step – fill out all of these fields - TOTAL DRIVERS ADDED A ENROLLMENT, TOTAL DRIVERS DELETED NO FEE, FOR ENROLLMENT ONLY, I certify or declare under penalty, and SIgNATURE X with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Simple tips to fill in inf 1100 rev 8 2018 step 2

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Completing segment 3 in inf 1100 rev 8 2018

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