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Employee Driver Statement

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EMPLOYEE DRIVER STATEMENT

Personal Information

Position Information

Reporting Manager:     Start Date:     Salary/Rate: $

Driver Information

Driver's License Number:     State of Issue:     Class/Endorsements:

License Expiration Date:     Years Licensed:

Driving History

Have you been involved in any motor vehicle accidents in the past 5 years?

Have you received any moving violations, citations, suspensions, revocations, or DUI/DWI convictions in the past 5 years?

Employment History (Most Recent First)

Education

Professional References

Legal Disclosures & Authorizations

At-Will Employment: I understand that, unless otherwise expressly agreed in writing by an authorized representative of the Company, my employment is at-will and may be terminated by either party at any time, with or without cause or notice.

Equal Employment Opportunity: The Company provides equal employment opportunity to all applicants and employees without regard to protected characteristics as defined by applicable law.

I authorize the Company and its agents to obtain and review my motor vehicle record (MVR) and to contact my previous employers, insurers, and other references for purposes of evaluating my qualifications to operate vehicles on behalf of the Company. I release those parties from liability for providing such information.

Safety and Compliance: I agree to comply with all Company vehicle safety policies, maintenance reporting procedures, and applicable state and federal motor vehicle laws when operating vehicles on Company business. I will promptly report any accidents, citations, license suspensions, or other driving-related events to my supervisor.

Applicant Certification and Authorization

I certify under penalty of perjury that the foregoing information is true, correct, and complete to the best of my knowledge. I understand that falsification, omission, or misrepresentation of information is grounds for disciplinary action up to and including termination of employment or withdrawal of an offer of employment. I further authorize the Company to verify any information provided on this form and to obtain additional records as necessary to evaluate my eligibility to operate vehicles for Company business.

Printed Name:

Signature:

Date:

Enter text✕

What an Employee Driver Statement Is and when it matters

An Employee Driver Statement is a written attestation completed by an employee who operates a company vehicle or drives on behalf of the employer. It documents the employee's identity, license information, driving record disclosures, authorization to drive, and acknowledgment of company vehicle policies, insurance responsibilities, and safety requirements. Employers use the form to assess risk, verify qualifications, and create a personnel record that supports training, incident response, and insurance claims. The statement is often combined with a motor vehicle record (MVR) release and may be retained in the employee’s personnel file.

Why a clear Employee Driver Statement matters for employers and drivers

A formal statement creates a verifiable record of authorization, liability allocation, and compliance with internal safety policies and external insurance requirements. It reduces ambiguity after an incident and supports consistent screening, training, and disciplinary processes.

Why a clear Employee Driver Statement matters for employers and drivers

Who completes and reviews the Employee Driver Statement

Use the statement as both a screening tool on hire and a periodic re-certification for ongoing drivers.

  • Employees required to drive on company time, including sales, delivery, and service personnel.
  • Human resources and fleet managers who verify licenses, insurance status, and training completion.
  • Risk managers and insurance adjusters who rely on documented acknowledgements after incidents.

Core elements to include in a professional Employee Driver Statement

A complete statement balances identification, legal acknowledgment, and operational details. Each element reduces post-incident disputes and streamlines administrative review.

Driver Identity

Full legal name and date of birth as shown on government ID; used to match DMV records and verify the correct individual signed the statement.

License Details

Driver license number, issuing state, class/type, and expiration date recorded to confirm eligibility and to trigger MVR checks.

Driving History

Self-disclosed accidents, moving violations, suspensions in the prior 3–5 years; employers typically verify via an MVR release.

Authorization

Statement that the employee is authorized to drive for business purposes and agrees to follow employer policies while operating a vehicle.

Insurance Acknowledgment

Acknowledges employee understands employer insurance limits, personal coverage responsibilities, and reporting requirements after incidents.

Policy Acceptance

Employee signs to confirm receipt and understanding of company vehicle policy, drug and alcohol rules, mobile device restrictions, and disciplinary consequences.

Step-by-step: completing an Employee Driver Statement

Follow these sequential steps to complete and submit the statement so HR can verify qualifications and retain a compliant record.

  • 01
    Provide identification: Enter full name, DOB, and license details for DMV matching.
  • 02
    Disclose history: Report accidents, violations, and suspensions for the lookback period.
  • 03
    Acknowledge policies: Read and confirm understanding of vehicle and safety rules.
  • 04
    Sign and submit: Sign (electronic or wet) and deliver to HR or fleet admin.

Typical digital workflow settings for online completion

Configure the online template to capture identity, verify the signer, and route documents automatically to HR and risk teams.

Field Configuration
Authentication Email link or SMS code; use higher assurance for sensitive roles.
Conditional Fields Show additional questions if accidents or suspensions reported.
Routing Order Employee → Supervisor → HR → Fleet Manager
Audit Log Capture timestamp, IP, and signer actions for the record.

Where completed statements typically go and how they are processed

After the employee signs, route the document to specific teams for verification, recordkeeping, and any required follow-up.

  • HR personnel: Receives and stores the signed statement in the employee personnel file.
  • Fleet manager: Reviews authorizations, assigns vehicles, and schedules training if needed.
  • Risk/Insurance: Uses statement to validate coverage decisions and support claims.
  • Supervisor: Confirms operational readiness and enforces policy compliance.

Digital signing and technical requirements for secure e-submission

Ensure the platform supports secure storage, export to common formats, and audit logs to satisfy recordkeeping and insurance requirements.

  • File formats: Use PDF or DOCX to preserve formatting and enable embedded fields.
  • Authentication options: Email, SMS code, or stronger methods such as knowledge-based checks for higher-risk drivers.
  • Integrations: Connect with HRIS, payroll, or fleet systems to automate storage and alerts.

Timing rules: when the Employee Driver Statement should be completed

Complete and retain the statement at specific points in employment to manage liability and insurance eligibility.

At hiring:

Complete before driving duties commence; ties to onboarding and MVR checks.

Annual reauthorization:

Update each year or per company policy to capture new incidents.

After incidents:

Complete an updated statement immediately following accidents or moving violations.

License changes:

Re-submit the statement when license status or classification changes.

Policy updates:

Obtain a new acknowledgment when vehicle policies materially change.

Frequent mistakes to avoid when preparing or submitting the form

  • Entering abbreviated names or nicknames that fail to match DMV records and cause MVR lookup failures or delays.
  • Failing to list recent citations or suspensions, which can lead to insurance denial or disciplinary action.
  • Using inconsistent date formats (e.g., DD/MM/YYYY) that obstruct automated processing and record reconciliation.
  • Not capturing a clear signature and timestamp, leaving disputes about when the employee agreed to policies.

Consequences of an incorrect, incomplete, or falsified Employee Driver Statement

Insurance denial: Claims may be denied if material omissions or falsehoods are discovered.
Disciplinary action: Employment consequences up to termination for falsifying driving history.
Liability exposure: Employer and employee may face increased liability for negligence or unauthorized driving.
Regulatory fines: Sector-specific penalties may apply where licensing or reporting rules are violated.
Operational disruption: Unscheduled suspensions of driving privileges can interrupt business operations.
Record disputes: Inaccurate documentation can lengthen claims investigations and legal proceedings.

Comparing eSignature vendors for managing Employee Driver Statements

Vendor pricing and features vary; the table below highlights starting prices, trial availability, and common compliance features to consider when choosing an eSignature provider.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial Yes, 7-day No No Yes, limited Yes, limited
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

FAQs: common questions about Employee Driver Statements

Answers to frequent questions about completion, electronic signatures, notarization, and recordkeeping for the Employee Driver Statement.


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