Employee CDL Document

EMPLOYEE CDL DOCUMENT

Personal Information

Employee Name:

Position Information

Commercial Driver's License (CDL) Details

CDL Number:   Issuing State:   Expiration:

CDL Class: Class A Class B Class C

Endorsements (check all that apply): H P N T X S

Restrictions (list any state-imposed restrictions or codes):

Driving Experience & Qualifications

Years of commercial driving experience:

Vehicle Authorization & Limitations

Maximum authorized gross vehicle weight rating (GVWR):

Employment History (Most Recent First)

Education

References (Professional)

Legal Disclosures & Authorizations

At-Will Employment: Employee acknowledges that employment with the employer is on an at-will basis, meaning either the employer or the employee may terminate the employment relationship at any time, with or without cause or advance notice, unless a separate written agreement signed by an authorized company representative states otherwise.

Equal Opportunity: Employer is an equal opportunity employer. Employment decisions are made without regard to race, color, religion, sex, national origin, age, disability, genetic information, or any other status protected by applicable law.

Authorization to Obtain Records: By signing below, I authorize the employer and its agents to obtain and review my motor vehicle record (MVR), driving history, DOT drug and alcohol testing records, pre-employment and post-accident drug test results, employment history, and other records relevant to my qualification to operate commercial motor vehicles. I authorize prior employers, licensing agencies, medical examiners, and testing facilities to release such records.

Drug and Alcohol Testing: I understand that as a condition of employment and continued qualification to operate commercial motor vehicles, I must submit to pre-employment, random, post-accident, reasonable suspicion, return-to-duty, and follow-up drug and alcohol testing in accordance with company policy and applicable law. Refusal to submit to testing or a positive test result may result in disciplinary action up to and including termination.

Convictions and License Actions: I certify that the information I provide below concerning license suspensions, revocations, DUI/DWI convictions, and other disqualifying events is true and complete. I agree to promptly report any changes to my license status or disqualifying events to the employer.

Consent & Certification

I certify that all information contained in this form is true, complete and correct to the best of my knowledge. I understand that omission, falsification, or misrepresentation of information may result in rejection of employment or termination. I authorize the employer to contact my listed references, prior employers, licensing agencies, medical examiners, and testing facilities to verify the information contained herein and to obtain any additional information necessary to determine my qualification to operate commercial motor vehicles.

I release from liability all persons and organizations that provide or receive information in good faith regarding my background, driving record, qualifications, or fitness to drive for the purposes described in this document.

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