I authorize you to make such investigations and inquiries of my personal, employment, driving record, criminal history as required by 49 CFR 391.15(c), financial or medical history, medical certification pursuant to 49 CFR 391.41, and other related matters as may be necessary in arriving at a decision as to whether I can be a driver for Motor Carrier.
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 event of association, I understand that false or misleading information given in my application or interview(s) may result in termination of my driver status. I understand, also, that I am required to abide by all rules and regulations of the Motor Carrier as well as the Federal Motor Carrier Safety Regulations. I understand if I am selected to drive for the Motor Carrier that I will serve a probationary period.
I understand that information I provide regarding current and/or previous 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(d) and (e). I understand that I have the right to:
• Review information provided by 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.