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Driver Application

Basic Infromation

Per FMCSA’s 391.23 (investigation and inquiries), subpart (J): (Driver) 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 re-send the corrected information to the prospective employer; and have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and cannot agree on the accuracy of the information.

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, or the presence of a non-job related medical condition or handicap.

Address For Past 3 Years

Physical History

Experience And Qualifications - Driver

Accident Record

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. I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. As a commercial CDL driver I hereby release employers, schools or persons from all liability in responding to inquiries 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 understand, also, that I am required to abide by all rules and regulations of the Company, as permitted by Law.

Driver Work History

All drivers’ applicants to drive in intra or interstate commerce must provide the following information on all work during the preceding 10 years. Please complete the following, by date order including those date periods in which you were not working, or worked as a sole proprietor.

Please list your work history beginning with the most recent.

Dot Mandated Driver’s Acknowledgment Of Logs Program

This internal rule applies to all Owner Operators, and Drivers operating under the below mentioned carrier. This company rule mandates the following:
  1. All logs MUST be turned in to the carrier company; including off duty date logs.
  2. Logs MUST be totally completed as per DOT requirements including compliance with driving and on duty hours.
  3. Copies of all supportive documentation such as fuel and toll receipts MUST also be turned in to the carrier for false log verification.

As per company rule any violation of this mandated regulation could represent grounds for disciplinary actions including the termination of our services within the company.

Dot Mandated Driver’s Acknowledgment Of Logs Program

The Federal Motor Carrier Safety Administration has implemented a strict policy that prohibits the use if hand held communications devices. In responce to this regulation, the compnay is implementing the following policies:

  1. Cell phone use while operating a company vehicle is expressly prohibited. This prohibition includes the use of the following:
    • Cell Phones
    • PDA's
    • Texting
    • Qualcomm or similar devices
  2. If you are required to mae or receive call, find a safe location (not the shoulder of the highway) and park your vehicle before using a communication device.
  3. If you receive an incoming call while driving, allow it go to voice mail and,if necessary, respond after finding a safe place to stop your vehicle.
  4. Altough not prohibited by federal regulation, the company believes that bluetooth devices cerate a distraction for the driver and is therefore prohibiting the use of such devices while driving.
  5. If making an emergency call, find a safe location to park your vehicle prior to using the phone.

Company is dedicated to both compliance with state and federal laws and is committed to operating safely. Distracted driving represents an unacceptable risk to the public. Driver who violate the rules governing hand-held communication devices shall be subject to disciplinary action upto and including termination.

Certification Of Violations / Annual Review Of Driving Record

Motor Carrier Instructions: Each motor carrier shall at least once every 12 months, require each driver to prepare and furnish it with a list of all violations of motor vehicle traffic laws and ordinances (other than violations involving only of which the driver has been convicted, or on account of which he/she has forfeited bond or collateral during the preceding parking) 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).

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.

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.

Drug & Alcohol Clearinghouse Consent For Limited Queries

Notice To Driver: The Commercial Driver's License (CDL) Drug & Alcohol Clearinghouse is a federal database containing information about CDL drivers who have violated the Federal Motor Carrier Safety Administration's (FMCSA's) drug or alcohol regulations in 49 CFR Part 382. Whether you have committed such a violation or not, each motor carrier for whom you drive is required to check whether the Clearinghouse has any information about you, both at the time of hire and annually. When conducting an annual inquiry, the motor carrier has the option to request a "limited" report that only indicates whether the Clearinghouse has any information about you; it does not release any violation or testing information. Before a motor carrier may request a limited report, they must have your written authorization, per $382.701(b). This authorization may be valid for more than one year. If a limited query ever reveals that the Clearinghouse has information about you, you will be required to log in to the Clearinghouse website within 24 hours to grant electronic consent for the motor carrier to obtain your full Clearinghouse record.

Notice To Motor Carrier: This consent form authorizes you to run a "limited query" to check whether the Clearinghouse has information about the driver identified below. If it does, then you must obtain a full Clearinghouse record within 24 hours, per $382.701(b). This consent form must be retained until 3 years after the date of the last limited query you perform for this driver, based on the authorization below.

Authorization:

I, Alex Jhon hereby authorize Minnesota Freight LLC INC. to conduct limited annual queries of the FMCSA's Drug & Alcohol Clearinghouse, to determine if a Clearinghouse record exists for me. This consent is valid from the date shown below until my employment with the above-named motor carrier ceases or until I am no longer subject to the drug and alcohol testing rules in 49 CFR Part 382 for the above-named motor carrier. I understand that if any limited query reveals that the Clearinghouse contains information about me, I must grant electronic consent within 24 hours, via the Clearinghouse website, for the motor carrier to obtain my full Clearinghouse record. Refusal to provide such consent will result in my removal from safety-sensitive duties.

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