HR Driver Approval Packet

HR DRIVER APPROVAL PACKET

Personal Information

Full legal name:

Date of birth:   SSN (last 4):

Position & Assignment

Reporting manager:   Requested start date:

Full-time    Part-time    Temporary/Seasonal

Driver License & Qualifications

Issuing state:   License class:   Expiration date:

I hold a CDL    Endorsements (list):

Driving Experience

Employment History (Most Recent First)

Employer 1

Job title:   Start date:   End date:

Employer 2

Job title:   Start date:   End date:

Accident & Violation History (Past 3 Years)

Medical & Drug Testing

DOT medical card holder: Yes    Medical exam date:

I consent to pre-employment and random drug and alcohol testing as required for safety-sensitive positions.

Background, MVR & Reference Checks — Authorization

I authorize the Company and its agents to obtain and review my driving record, criminal background, employment history, and other background information necessary to determine my suitability for a driver position. I understand that this information may be obtained from previous employers, licensing authorities, law enforcement agencies, medical examiners, and other sources. I voluntarily release those parties from liability for providing such information.

Applicant initials:

Consent to Motor Vehicle Record (MVR) check    Consent to criminal background check

References (Professional)

Legal Disclosures & Company Policies

At-Will Employment: Unless otherwise agreed in a written employment agreement signed by an authorized Company representative, employment with the Company is at-will. Either the employee or the Company may terminate the employment relationship at any time, for any lawful reason, with or without cause or prior notice.

Equal Employment Opportunity: The Company is an equal opportunity employer. Employment decisions are based on legitimate business reasons and consistent with applicable law. Discrimination or harassment based on protected characteristics is prohibited.

Safety-sensitive duties: I understand that driver positions are safety-sensitive and that compliance with all Company safety policies, training, and testing (including drug and alcohol testing) is a condition of continued employment. Failure to comply may result in discipline up to and including termination.

Applicant Certification & Release

I certify that the information provided in this packet is true, accurate and complete to the best of my knowledge. I understand that material misstatements, omissions, or falsification may disqualify me from consideration or be grounds for immediate termination if discovered after hire. I authorize investigation of all statements contained herein and authorize employers, schools, licensing agencies, and other persons to provide information requested by the Company for employment purposes.

I further authorize the release of my motor vehicle records and other investigation results to the Company and its insurers for the purpose of determining my eligibility to operate Company vehicles. I release all parties from liability for any damage that may result from furnishing such information.

Applicant initials:

Attachments / Required Documents Checklist

Copy of valid driver's license    CDL documentation (if applicable)

DOT medical card or medical certificate    Signed MVR/background consent

HR Use Only (Do Not Complete — For HR)

Approved for driving duties: Yes    No

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