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The Application For Driver form is a crucial document for anyone seeking employment as a commercial driver. This form is designed to gather essential information about an applicant's background, including personal details, driving experience, and employment history. Carriers must ensure that the form is filled out completely, as incomplete applications will not be considered. Key sections of the form include the applicant's contact information, residency history, and a declaration of legal eligibility to work in the United States. Additionally, it requires a detailed account of the applicant's driving licenses, accident records, and traffic violations over the past three years. The form also emphasizes the importance of listing all relevant employment history for the last ten years, particularly focusing on any positions subject to Federal Motor Carrier Safety Regulations. Lastly, it includes a section for the applicant to authorize background checks and verify the accuracy of the information provided. This comprehensive approach ensures that carriers can make informed hiring decisions while adhering to regulatory requirements.

Document Preview

This is an example driver employment application. Carriers do not need to use this exact form, but must have a completed and signed employment application for all drivers that contains the information listed in 49 CFR 391.21.

DRIVER EMPLOYMENTAPPLICATION

[COMPANY NAME, ADDRESS, PHONE NUMBER, AND EMAIL]

An Equal Opportunity Employer

COMPLETE IN FULL OR IT WILL NOT BE CONSIDERED.

 

 

 

 

APPLICANT INFORMATION

 

 

 

 

 

 

 

 

 

 

MIDDLE

 

 

 

LAST

 

 

 

 

 

FIRST NAME

 

 

NAME

 

 

 

NAME

 

 

 

 

 

PHONE

 

 

EMAIL

 

 

 

 

 

 

 

 

 

DATE OF BIRTH

 

 

SOCIAL SECURITY #

 

 

 

 

 

 

 

 

DATE OF

 

POSITION

 

 

 

 

 

DATE AVAILABLE

 

 

 

APPLICATION

 

APPLIED FOR

 

 

 

 

 

FOR WORK

 

 

 

Do you have legal right to work in the United States?

☐ YES ☐ NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PREVIOUS THREE YEARS RESIDENCY

 

 

 

 

 

 

 

 

 

Attach additional sheet if more space is needed

 

 

 

 

 

 

 

 

 

 

 

 

 

ZIP

# OF YEARS

 

STREET

 

 

 

 

CITY

 

 

STATE

 

CODE

AT ADDRESS

CURRENT

 

 

 

 

 

 

 

 

 

 

 

 

 

MAILING

 

 

 

 

 

 

 

 

 

 

 

 

 

PREVIOUS

 

 

 

 

 

 

 

 

 

 

 

 

 

PREVIOUS

 

 

 

 

 

 

 

 

 

 

 

 

 

PREVIOUS

 

 

 

 

 

 

 

 

 

 

 

 

 

LICENSE INFORMATION

No person who operates a commercial motor vehicle shall at any time have more than one driver’s license (49 CFR 383.21). I certify that I do not have more than one motor vehicle license, the information for which is listed below. Include all licenses held for the past 3 years; attach additional sheets if needed.

STATE

LICENSE #

TYPE/CLASS

ENDORSEMENTS

EXPIRATION DATE

PREVOIUSLY HELD LICENSES

DRIVING EXPERIENCE

CLASS OF

 

TYPE OF EQUIPMENT (VAN, TANK, FLAT, ETC.)

 

DATE FROM

 

DATE TO

APPROX # OF

EQUIPMENT

 

 

 

MILES (TOTAL)

STRAIGHT

 

 

 

 

 

 

 

TRUCK

 

 

 

 

 

 

 

TRACTOR &

 

 

 

 

 

 

 

SEMI-TRAILER

 

 

 

 

 

 

 

TRACTOR &

 

 

 

 

 

 

 

2 TRAILERS

 

 

 

 

 

 

 

TRACTOR &

 

 

 

 

 

 

 

TANKER

 

 

 

 

 

 

 

OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Page 1 of 4

ACCIDENT RECORD FOR THE PAST 3 YEARS

Attach additional sheet if more space is needed. Check this box if none

DATES (List most recent first)

NATURE OF ACCIDENT (Head-on, rear-end, upset, etc.)

CHEMICAL SPILLS

# FATALITIES # INJURIES (Y/N)

TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS (OTHER THAN PARKING VIOLATIONS)

Attach additional sheet if more space is needed. Check this box if none

DATE CONVICTED (Month/Year)

VIOLATION

STATE OF

VIOLATION PENALTY (Forfeited bond, collateral and/or points)

Have you ever been denied a license, permit, or privilege to operate a motor vehicle?

☐ YES

☐ NO

If yes, explain

 

 

Has any license, permit, or privilege ever been suspended or revoked?

☐ YES

☐ NO

If yes, explain

 

 

EMPLOYMENT HISTORYZ

The Federal Motor Carrier Safety Regulations (49 CFR 391.21) require that all applicants wishing to drive a commercial vehicle list all employment for the last three (3) years. In addition, if you have driven a commercial vehicle previously, you must provide employment history for an additional seven (7) years (for a total of ten (10) years). Any gaps in employment in excess of one (1) month must be explained.

Start with the last or current position, including any military experience, and work backwards (attach separate sheets if necessary). You are required to list the complete mailing address, including street number, city, state, zip; and complete all other information.

CURRENT (MOST RECENT) EMPLOYER

 

 

 

 

 

 

NAME

 

 

 

 

 

PHONE

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

FROM

 

 

 

TO

 

POSITION HELD

 

 

MO/YR

 

 

 

MO/YR

 

REASON FOR LEAVING

 

 

 

 

 

SALARY

 

EXPLAIN ANY GAPS IN

 

 

 

 

 

 

 

EMPLOYMENT (Include

 

 

 

 

 

 

 

month/year & reason)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Page 2 of 4

While employed here, were you subject to the Federal Motor Carrier Safety Regulations?

 

 

 

 

☐ YES

☐ NO

 

Was the job designated as a safety-sensitive function in any Department of Transportation-regulated

 

 

 

 

 

 

mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?

 

 

 

 

☐ YES

☐ NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECOND (MOST RECENT) EMPLOYER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME

 

 

 

 

 

 

 

 

PHONE

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FROM

 

 

TO

 

 

 

 

 

 

POSITION HELD

 

 

 

 

MO/YR

 

 

MO/YR

 

 

 

 

 

 

REASON FOR LEAVING

 

 

 

 

 

 

 

SALARY

 

 

 

 

 

EXPLAIN ANY GAPS IN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYMENT (Include

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

month/year & reason)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

While employed here, were you subject to the Federal Motor Carrier Safety Regulations?

 

 

 

 

☐ YES

☐ NO

Was the job designated as a safety-sensitive function in any Department of Transportation-regulated

 

 

 

 

 

 

mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?

 

 

 

 

☐ YES

☐ NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THIRD (MOST RECENT) EMPLOYER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME

 

 

 

 

 

 

 

 

PHONE

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FROM

 

 

TO

 

 

 

 

 

 

POSITION HELD

 

 

 

 

MO/YR

 

 

MO/YR

 

 

 

 

 

 

REASON FOR LEAVING

 

 

 

 

 

 

 

SALARY

 

 

 

 

 

EXPLAIN ANY GAPS IN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYMENT (Include

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

month/year & reason)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

While employed here, were you subject to the Federal Motor Carrier Safety Regulations?

 

 

 

 

☐ YES

☐ NO

 

Was the job designated as a safety-sensitive function in any Department of Transportation-regulated

 

 

 

 

 

 

mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?

 

 

 

 

☐ YES

☐ NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EDUCATION

 

 

 

 

 

 

 

 

 

SCHOOL

 

NAME & LOCATION

 

 

COURSE OF STUDY

YEARS

GRADUATE

DETAILS

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPLETED

Y

N

 

 

 

 

High School

 

 

 

 

 

 

 

 

 

 

 

 

 

College

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER QUALIFICATIONS

Please list any other qualifications that you have and which you believe should be considered.

Page 3 of 4

TO BE READ AND SIGNED BY APPLICANT

I authorize you to make investigations (including contacting current and prior employers) into my personal, employment, financial, medical history, and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, health care providers, and other persons from all liability in responding to inquiries and releasing information 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 also understand that I am required to abide by all rules and regulations of the Company.

I understand that the information I provide regarding my current and/or prior employers may be used, and those employer(s) will be contacted for the purpose of investigating my safety performance history as required by 49 CFR 391.23. 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 resend the corrected information to the prospective employer; and

Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge. Note: A motor carrier may require an applicant to provide more information than that required by the Federal Motor Carrier Safety Regulations.

Applicant Signature

Applicant Name (printed)

Date

Page 4 of 4

Form Specifications

Fact Name Description
Governing Law The application must comply with 49 CFR 391.21, which outlines the requirements for driver employment applications.
Equal Opportunity Employer The form states that the employer is an Equal Opportunity Employer, promoting non-discrimination in hiring practices.
Completion Requirement Applicants must complete the form in full; incomplete applications will not be considered.
Residency Disclosure Applicants are required to provide their residency history for the past three years, including addresses and duration at each location.
License Information Applicants must declare all driver's licenses held in the past three years, adhering to the stipulation of having only one active license (49 CFR 383.21).
Accident Record Applicants need to disclose any accidents from the past three years, including details such as nature of the accident and any fatalities or injuries.
Employment History The form requires a detailed employment history for the last three years, with additional information needed for the previous seven years if applicable.

Application For Driver: Usage Guidelines

Completing the Application for Driver form is an essential step in the hiring process for drivers. This form gathers necessary information about the applicant's background, driving history, and qualifications. Once the form is filled out, it will be submitted to the employer for review, along with any required supporting documents.

  1. Header Information: At the top of the form, fill in the company name, address, phone number, and email. Ensure this section is complete.
  2. Applicant Information: Enter your first, middle, and last name. Provide your phone number, email address, date of birth, social security number, and the date you are applying for the position. Indicate your availability for work and confirm your legal right to work in the United States by checking the appropriate box.
  3. Previous Residency: List your residency for the last three years. Include the street address, city, state, and ZIP code, along with the number of years you lived at each address. If more space is needed, attach an additional sheet.
  4. License Information: Provide details about all driver’s licenses you have held in the past three years, including the state, license number, type/class, endorsements, and expiration date. Confirm that you do not hold more than one motor vehicle license.
  5. Driving Experience: Detail your driving experience, specifying the type of equipment you have driven, the dates of your experience, and the total number of miles driven. Include various categories such as straight truck, tractor & semi-trailer, and others.
  6. Accident Record: List any accidents you have been involved in over the past three years, including the nature of the accident, dates, and any fatalities or injuries. If none, check the appropriate box.
  7. Traffic Convictions: Record any traffic convictions or forfeitures in the past three years, excluding parking violations. Provide the date, violation, state of violation, and penalty. If none, check the appropriate box.
  8. Employment History: List your employment for the last three years, including military experience. Start with your most recent employer and provide the name, phone number, address, dates of employment, position held, reason for leaving, and salary. Explain any gaps in employment, if applicable.
  9. Education: Fill in your educational background, including the school name, location, course of study, years completed, and whether you graduated from high school, college, or other education.
  10. Other Qualifications: Include any additional qualifications that you believe are relevant to your application.
  11. Signature Section: Read the authorization and certification statement. Sign and print your name, and provide the date of signing to confirm that all information is accurate and complete.

Your Questions, Answered

What is the purpose of the Application For Driver form?

The Application For Driver form is used by carriers to gather necessary information from applicants seeking employment as drivers. It ensures that all required details are collected, as mandated by federal regulations. This includes personal information, driving history, and previous employment records.

What information do I need to provide on the form?

You must complete the form in full, providing details such as your name, contact information, date of birth, Social Security number, and employment history for the past ten years. Additionally, you will need to disclose your driving experience, accident record, and any traffic violations. If applicable, include information about your education and other qualifications.

Can I use a different form instead of the one provided?

What happens if I do not complete the form fully?

If the form is not completed in full, it will not be considered for employment. It is essential to provide all requested information to avoid delays or disqualification from the application process.

What should I do if I have gaps in my employment history?

You need to explain any gaps in employment that exceed one month. Include the month and year of the gap along with the reason for it. This transparency helps employers understand your work history better.

What rights do I have regarding the information I provide?

You have the right to review the information provided by your current and previous employers. If you find errors, you can request corrections. If there is a disagreement about the accuracy of the information, you can attach a rebuttal statement to the records.

Common mistakes

  1. Not providing complete contact information. Applicants often leave out their phone number or email address, which can hinder communication.

  2. Failing to list all previous employment. Many applicants forget to include jobs held in the last three years or do not provide details for positions held longer than that.

  3. Inaccurate or incomplete license information. Some applicants do not include all licenses held in the past three years or fail to mention expired licenses.

  4. Omitting gaps in employment. When there are breaks in work history, applicants often neglect to explain these gaps, which can raise questions.

  5. Not signing the application. Some applicants forget to provide their signature at the end of the form, which is required for the application to be valid.

Documents used along the form

When applying for a driver position, several forms and documents are commonly required alongside the Application for Driver form. These documents help ensure that the application process is thorough and compliant with regulations.

  • Background Check Consent Form: This form authorizes the employer to conduct background checks, including criminal history and driving records, to assess the applicant's suitability for the position.
  • Medical Examination Report: A report completed by a licensed medical professional, confirming that the applicant meets the physical requirements to operate a commercial vehicle.
  • Drug and Alcohol Testing Consent Form: This document gives permission for the employer to conduct drug and alcohol testing, as required by federal regulations for commercial drivers.
  • Motor Vehicle Record (MVR): A document obtained from the Department of Motor Vehicles that provides a summary of the applicant's driving history, including any violations or accidents.
  • Proof of Identity and Work Authorization: Documents such as a passport or a Social Security card that verify the applicant's identity and legal right to work in the United States.
  • Employment Verification Form: A form used to confirm the applicant's previous employment history, including dates of employment and positions held.
  • Safety Performance History Record: A record detailing the applicant's safety performance with previous employers, as mandated by federal regulations.

These documents collectively support the application process and help employers make informed hiring decisions. Ensuring that all required forms are completed accurately and submitted in a timely manner can streamline the hiring process.

Similar forms

  • Job Application Form: Similar to the driver application, a general job application form collects personal information, employment history, and qualifications. Both require the applicant's signature to confirm the accuracy of the information provided.
  • Commercial Driver’s License (CDL) Application: This form is specifically for obtaining a CDL. Like the driver application, it requires personal details, residency history, and driving experience, ensuring that the applicant meets the necessary legal requirements.
  • Background Check Authorization Form: This document allows employers to conduct background checks on applicants. It parallels the driver application by requiring the applicant's consent and personal information for verification purposes.
  • Employment Verification Form: Used to confirm an applicant's previous employment, this form is similar in that it collects employment history details. Both documents aim to ensure the accuracy of the applicant's work experience.
  • Release of Information Form: This form permits employers to obtain information from previous employers or educational institutions. Like the driver application, it emphasizes the importance of accurate and truthful information.
  • Medical Examination Report Form: Required for commercial drivers, this form assesses an applicant's medical fitness. It shares similarities with the driver application in that it collects personal information and requires a signature for consent.
  • Safety Performance History Record: This document details an applicant's safety record and driving history. It complements the driver application by ensuring that the applicant's past performance aligns with safety regulations.
  • Drug and Alcohol Testing Consent Form: This form is used to obtain consent for drug and alcohol testing. Similar to the driver application, it requires the applicant's acknowledgment of testing policies and regulations.
  • Equal Employment Opportunity (EEO) Form: This form collects demographic information to ensure compliance with EEO laws. It is similar to the driver application in that both forms include an equal opportunity statement and seek to eliminate discrimination.
  • W-4 Tax Form: While primarily for tax withholding, the W-4 collects personal information similar to the driver application. Both forms require the applicant's signature to validate the information provided.

Dos and Don'ts

Things to Do When Filling Out the Application For Driver Form:

  • Complete all sections of the application thoroughly.
  • Provide accurate and up-to-date contact information.
  • Attach additional sheets if you need more space for any section.
  • Sign and date the application before submission.
  • Double-check for any spelling or factual errors before sending.

Things to Avoid When Filling Out the Application For Driver Form:

  • Do not leave any required fields blank.
  • Avoid providing false or misleading information.
  • Do not forget to explain any gaps in your employment history.
  • Refrain from using abbreviations that may confuse the reviewer.
  • Do not submit the application without reviewing it for completeness.

Misconceptions

  • Misconception 1: The Application for Driver form is mandatory for all carriers.

    In reality, while the form provides a useful template, carriers are not required to use it. They must, however, have a completed and signed employment application that includes the necessary information as outlined in the regulations.

  • Misconception 2: Applicants can skip sections if they find them irrelevant.

    This is not true. The form must be completed in full. Missing information may result in the application not being considered. Every section serves a purpose in evaluating the applicant's qualifications and history.

  • Misconception 3: Previous employment history is not important if there are gaps.

    On the contrary, any gaps in employment exceeding one month must be explained. This requirement helps employers understand an applicant's work history and any potential issues that may arise from extended periods of unemployment.

  • Misconception 4: The application process does not involve background checks.

    This is a common misunderstanding. The form includes a section where applicants authorize investigations into their personal and employment history. Employers are allowed to contact previous employers to assess the applicant's safety performance history.

Key takeaways

Completing the Application For Driver form is a critical step in the hiring process for commercial drivers. Here are some key takeaways to ensure the application is filled out accurately and effectively:

  • Full Completion is Essential: Every section of the application must be completed. Incomplete applications will not be considered.
  • Provide Accurate Information: Ensure all personal details, such as your name, contact information, and social security number, are correct.
  • Residency History Matters: List your previous three years of residency accurately. If more space is needed, attach an additional sheet.
  • Licensing Compliance: Confirm that you hold only one driver’s license. List all licenses held in the past three years, including their details.
  • Detail Driving Experience: Include all relevant driving experience, specifying the type of equipment operated and total miles driven.
  • Accident and Violation Records: Disclose any accidents or traffic violations from the past three years. If none, check the appropriate box.
  • Employment History is Key: Provide a comprehensive employment history for the last ten years, including any gaps and reasons for leaving previous positions.

By following these guidelines, applicants can enhance their chances of a successful application process. Thoroughness and honesty are paramount in presenting qualifications for a driving position.