Driver Information Statement

DRIVER INFORMATION STATEMENT

Parties and Recitals

This Driver Information Statement is made between Company Name: and Driver Name: .

WHEREAS, the Company engages drivers to perform transportation services and requires detailed, accurate driver and vehicle information to assess eligibility and manage risk; and

WHEREAS, the Driver represents that the information provided in this Statement is true, complete, and provided for the purpose of evaluating qualification for driving duties and insurance underwriting; and

WHEREAS, the parties agree that submission of this Statement does not by itself constitute employment, an independent contractor relationship, or a guarantee of assignment, but is required for assignment consideration.

Driver Contact Information

Driver's License and Endorsements

License State:    License Number:    Class:    Expiration Date:

Vehicle and Insurance Information

Driving History and Declarations

In the past 5 years have you been involved in an accident resulting in injury or property damage? Yes No

In the past 3 years have you been convicted of any moving violations (DUI, reckless driving, excessive speeding, etc.)? Yes No

Have you ever had a commercial driver's license suspended, revoked, or denied? Yes No

Certifications, Authorizations and Background Checks

By signing below the Driver certifies the truthfulness of the statements contained herein and authorizes the Company and its agents to obtain motor vehicle records, insurance verification, and background checks as necessary to evaluate eligibility for driving assignments.

Driver authorizes release of records and agrees to notify Company within of any change to the information provided, including license suspension, address change, or insurance lapse.

Scope of Work

Payment Terms

Compensation Amount:    Payment Schedule:

Late Payment Fee: If any payment due to the Driver is not made when due, Company may impose a late fee equal to on the outstanding balance, to the extent permitted by applicable law.

Term and Termination

Term Commencement Date:    Term Expiration Date (if any):

Either party may terminate this Statement or any assignment made pursuant to it for convenience upon providing written notice to the other party at least . Termination for cause may be immediate where required by safety concerns or regulatory obligations.

Confidentiality

Driver shall maintain in strict confidence all proprietary, business, customer, route, pricing, and compliance information obtained in connection with assignments performed for the Company, both during and after the term of this Statement. Confidential information does not include information that is or becomes publicly available through no breach by the Driver or is required to be disclosed by law or court order, provided that the Driver gives prompt notice to Company to permit protective measures.

Governing Law; Entire Agreement

This Statement shall be governed by and construed in accordance with the laws of the State/Jurisdiction: , without regard to choice-of-law principles.

This Statement, together with any attachments or addenda executed by the parties, constitutes the entire agreement between the parties with respect to the subject matter herein and supersedes all prior negotiations, understandings, and agreements, whether written or oral.

Certification

I certify under penalty of perjury and other applicable legal sanctions that all statements made in this Driver Information Statement are true and complete to the best of my knowledge. I understand that falsification, omission, or failure to disclose material information may result in denial of assignment, termination of any assignment, and may subject me to civil or criminal liability.

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