Class A CDL 23 years experience 3rd generation driver
Resume:
Trantham Services, Inc.
Alexandria, AL 36250
**-**-**** *:39:18PM CDT
IntelliApp
Thank you for your interest in Trantham Services, Inc. To apply for a driving position, please complete our online application for employment. Incomplete information will delay the processing of your application or prevent it from being submitted. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company. In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.
Personal Information
Name Timothy D Creamer
Residence 3 years or longer (If No,
previous addresses shown below)
Yes
Current Address 415 Russell Ln
City, State/Province Zip/Postal Weaver, AL 36277
Country United States
Residence 3 years or longer (If No,
previous addresses shown below)
Yes
SSN/SIN 6284
Date of Birth
Primary Phone 256-***-****
Cell Phone 256-***-****
Preferred method of contact Cell Phone
Best time to contact you Any
Email ad4rl9@r.postjobfree.com
Yes, I agree to receive information
concerning future opportunities or
promotions from Trantham Services, Inc.
by email or other commercial electronic
communications.
Yes
Would you like to receive communication
from Trantham Services, Inc. via text
message?
By participating, you consent to receive
Yes
1
text messages sent by an automatic
telephone dialing system, which may
contain recruiting/advertising messages.
Consent to these terms is not a condition
of being hired, contracted, or leased. You
may opt out at any time by texting STOP
GENERAL INFORMATION
What position are you applying for? Jacksonville AL - OTR Company Driver Are you legally eligible for employment in
the United States?
Yes
Are you currently employed? No
What date did your last employment end? 3/10/24
Do you read, write, and speak English? Yes
Have you ever worked for this company
before?
No
Enter start and end dates, location,
position, and reason for leaving:
Expiration date:
Please enter the names of any relatives
employed here:
Have you ever been known by any other
name?
No
Enter name:
How did you hear about us? Other
If "Driver Referral", please enter the
driver's name
If "Other", please explain
DRIVING EXPERIENCE
For each class of equipment, enter type of equipment (van, reefer, tank, etc.), start and end dates, and approximate number of total miles. If no experience in a class, enter
"NONE".
Straight Truck Mixer truck/ dump truck 3-5 years Tractor and Semi-Trailer Dry van/ reefer units/ flatbed 15 years Tractor - Two Trailers None
2
Other None
Which safe driving awards do you hold and
from whom?
EDUCATION
List highest grade completed: GED
List last school attended (name, city, and
state):
Licenses
License Number 147
Licensing Authority AL
Country US
License Class Class A
License Expiration Date 01-14-2026
DOT Medical Card Expiration Date 12-07-2024
Current License Yes
Commercial Driver License Yes
Endorsements
Tanker Endorsement Yes
HAZMAT Endorsement No
X Endorsement No
Doubles Triples Endorsement Yes
Other Endorsement No
Employment / Unemployment
Self Employed Hot shot
Company Self Employed Hot shot
Start Date 07-2023
End Date 03-2024
Address 415 Russell Ln
City, State/Province Zip/Postal Weaver, AL 36277-
Country United States
Phone 256-***-****
Position Held
3
Reason for leaving? Belly up
Were you terminated/discharged/laid off? No
Is this your current employer? Yes
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT, and
subject to drug and alcohol testing?
Yes
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven Other
Most common trailer Flatbed
Trailer length 32 to 44 feet
Jpar Trucking
PLEASE DO NOT CONTACT
Company Jpar Trucking
Start Date 01-2023
End Date 02-2024
Address
City, State/Province Zip/Postal Roanoke, AL
Country United States
Phone
Fax 334-***-****
Position Held
Reason for leaving? Left because of bad equipment
Were you terminated/discharged/laid off? Yes
Termination Explanation Stopped because of bad tires and the load was late so they let me go
Is this your current employer? No
May we contact this employer at this time? No
4
Did you operate a commercial motor
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT, and
subject to drug and alcohol testing?
Yes
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
LB3, LLC
Company LB3, LLC
Start Date 10-2022
End Date 01-2023
Address 63 County Road 206
City, State/Province Zip/Postal Wedowee, AL 36278
Country United States
Phone
Position Held Otr driver
Reason for leaving? Looking for better pay
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT, and
subject to drug and alcohol testing?
Yes
5
Areas Driven Southeast
Miles driven weekly 2000-2500
Pay Range (cents/mile)
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Webb Concrete Company Inc
Company Webb Concrete Company Inc
Start Date 01-2018
End Date 10-2022
Address 64 Hunnicutt St
City, State/Province Zip/Postal Heflin, AL 36264
Country United States
Phone 334-***-****
Position Held Company driver
Reason for leaving? Bad management
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT, and
subject to drug and alcohol testing?
Yes
Areas Driven Local
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven Class B Vehicle
Most common trailer Other
Trailer length Other
Vernon Milling Company, Inc.
Company Vernon Milling Company, Inc.
6
Start Date 03-2008
End Date 01-2018
Address 44080 Hwy 17
City, State/Province Zip/Postal Vernon, AL 35592
Country United States
Phone 205-***-****
Fax 205-***-****
Position Held
Reason for leaving? Bad equipment
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT, and
subject to drug and alcohol testing?
Yes
Areas Driven Southeast Midwest
Miles driven weekly 2500-3000
Pay Range (cents/mile)
Most common truck driven Tractor-Trailer
Most common trailer Tank Trailer
Trailer length 45 to 52 feet
CoreTrans, LLC
Company CoreTrans, LLC
Start Date 08-2001
End Date 03-2008
Address 603 Kit Cowan Road
City, State/Province Zip/Postal Somerset, KY 42501 Country United States
Phone 606-***-****
Fax 606-***-****
7
Position Held
Reason for leaving? Just ready for a change
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT, and
subject to drug and alcohol testing?
Yes
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven Tractor-Trailer
Most common trailer
Trailer length 53 feet or more
Trucking School
Start Date 06-2001
End Date 08-2001
School Southern Crescent tech
Address
Address 2
City, State/Province Thomaston, GA
Country US
Phone
Did you graduate? Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while attending this truck
school?
Yes
Did you perform any safety sensitive
functions at this truck school, regulated by
Yes
8
DOT, and subject to drug and alcohol
testing?
GPA 92
Hours of Instruction 200
Border Crossing No
Log Books Yes
Federal Motor Carrier Regulations Yes
Hazardous Materials Yes
FMCSR
Under FMCSR 391.15, are you currently
disqualified from driving a commercial
motor vehicle? [49 CFR 391.15]
No
Has your license, permit or privilege to
drive ever been suspended or revoked for
any reason? [49 CFR 391.21(b)(9)]
No
Have you ever been denied a license,
permit, or privilege to operate a motor
vehicle?[49 CFR 391.21(b)(9)]
No
Within the past two years, have you tested
positive, or refused to test, on a
pre-employment drug or alcohol test by an
employer to whom you applied, but did not
obtain, safety-sensitive transportation work
covered by DOT agency drug and alcohol
testing rules? [49 CFR 40.25(j)]
No
In the past three(3) years, have you ever
been convicted of any of the following
offenses: [49 CFR 391.15]:
Driving a commercial motor vehicle
with a blood alcohol concentration
("BAC") of .04 percent or more
·
Driving under the influence of
alcohol, as prescribed by state law
·
Refusal to undergo drug and
alcohol testing as required by any
jurisdiction for the enforcement of
Federal Motor Carrier Safety Act
regulations
·
Driving a commercial motor vehicle
under the influence of any 21
C.F.R. 1308.11 Schedule I
identified controlled substance, an
amphetamine, a narcotic drug, a
formulation of an amphetamine, or
·
No
9
a derivative of a narcotic drug
Transportation, possession, or
unlawful use of a 21 C.F.R.
1308.11 Schedule I identified
controlled substance,
amphetamines, narcotic drugs,
formulations of an amphetamine, or
derivatives of narcotic drugs while
you were on duty driving for a
motor carrier
·
Leaving the scene of an accident
while operating a commercial motor
vehicle
·
Or any other felony involving the
use of a commercial motor vehicle
·
Vehicle Accident Record
Were you involved in any accidents/incidents with any vehicle in the last 5 years (even if not at fault)?
No Accidents
Traffic Convictions \ Violations
Have you had any moving violations or traffic convictions in the past 3 years? No Violations
Criminal Record
Have you ever been convicted of a crime? Yes
Comment It's a simple poss felony wrong place
wrong time in 2019
Do you have any deferred prosecutions? No
Do you have criminal charges pending? No
Have you ever pled "guilty" to, been
convicted of, or pled "no contest" to a
felony?
Yes
Comment It's a simple poss felony wrong place
wrong time in 2019
If you have any felony convictions, do you
currently hold a minister's permit to enter
or exit Canada?
No
Have you, within the last five years, pled
"guilty" to, been convicted of, had
No
10
prosecution deferred in connection with, or
pled "no contest" to a misdemeanor?
Signature
Full Name Timothy D Creamer
IP Address 2600:1702:1bb0:3
Signature Date/Time 03-26-2024 1:39 PM
By signing my application below, I agree to use an electronic signature to demonstrate my consent. An electronic signature is as legally binding as an ink signature. This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.
Signed Date: 03-26-2024 1:39 PM
Signed:
Federal FCRA Summary of Rights Acknowledgment
By checking this box, I (a) acknowledge
that I have read and understand the
federal FCRA Summary of Rights and
have been given the opportunity to
copy/print the Summary of Rights and (b)
agree to use an electronic signature to
demonstrate my consent. An electronic
signature is as legally binding as an ink
signature.
Yes
PSP Disclosure and Authorization
By checking the box, I (a) acknowledge
that I have read and understand the PSP
Disclosure and Authorization and also
have been given the opportunity to
copy/print it, and (b) agree to use an
electronic signature to demonstrate my
consent. An electronic signature is as
legally binding as an ink signature.
Yes
11
Additional Consent or Certification
By checking the box, I (a) acknowledge
that I have read and understand the above
and also have been given the opportunity
to copy/print it, and (b) agree to use an
electronic signature to demonstrate my
consent. An electronic signature is as
legally binding as an ink signature.
Yes
FCRA Disclosure
By checking the box, I (a) acknowledge
that I have read and understand the above
and also have been given the opportunity
to copy/print it, and (b) agree to use an
electronic signature to demonstrate my
consent. An electronic signature is as
legally binding as an ink signature.
Yes
FCRA Authorization
By checking the box, I (a) acknowledge
that I have read and understand the above
and also have been given the opportunity
to copy/print it, and (b) agree to use an
electronic signature to demonstrate my
consent. An electronic signature is as
legally binding as an ink signature.
Yes
Employment Verification Acknowledgment and Release (DOT Drug and Alcohol) By checking the box, I (a) acknowledge
that I have read and understand the above
and also have been given the opportunity
to copy/print it, and (b) agree to use an
electronic signature to demonstrate my
consent. An electronic signature is as
legally binding as an ink signature.
Yes
Clearinghouse Release
By checking the box, I (a) acknowledge
that I have read and understand the above
and also have been given the opportunity
to copy/print it, and (b) agree to use an
electronic signature to demonstrate my
consent. An electronic signature is as
legally binding as an ink signature.
Yes
12
User Requested Copy
User requested a copy to be sent to this
email address ad4rl9@r.postjobfree.com.
Yes
13
DISCLOSURE FOR CONSUMER REPORTS
In connection with my application for employment (including contract) with Trantham Services, Inc., I understand consumer reports will be requested by Trantham Services, Inc. ("Company"). These reports may include, as allowed by law, the following types of information, as applicable: names and dates of previous employers, reason for termination of employment, work experience, education, accidents, licensure, credit, etc. I further understand that such reports may contain public record information such as, but not limited to: my driving record, CDLIS, workers' compensation claims, judgments, bankruptcy proceedings, criminal records, etc., from federal, state, and other agencies that maintain such records. In addition, investigative consumer reports (gathered from personal interviews, as applicable, with former employers or landlords, past or current neighbors and associates of mine, etc.) to gather information regarding my work or tenant performance, character, general reputation and personal characteristics, and mode of living (lifestyle) may be obtained. If I am hired (or contracted), I understand that Company can use this disclosure and authorization to continue to obtain such consumer reports throughout my employment or contract period. Printed Name:
Timothy D Creamer
Social Security #:
6284
Signed Date: 03-26-2024
Timothy D Creamer
415 Russell Ln
Weaver, AL 36277
Gender:
14
AUTHORIZATION FOR CONSUMER REPORTS
I hereby authorize procurement of consumer report(s) and investigative consumer report(s) by Company. If hired (or contracted), this authorization shall remain on file and shall serve as ongoing authorization for Company to procure such reports at any time during my employment or contract period. I authorize without reservation, any person, business or agency contacted by any consumer reporting agency retained by Company to furnish the above-mentioned information. This authorization is conditioned upon the following representations of my rights: I understand that I have the right to make a request to any consumer reporting agency ("Agency") that supplied the report to the Company upon proper identification, to obtain copies of any reports furnished to Company by the Agency and to request the nature and substance of all information in its files on me at the time of my request, including the sources of information, and the Agency, on Company's behalf, will provide a complete and accurate disclosure of the nature and scope of the investigation covered by any investigative consumer report(s). The Agency will also disclose the recipients of any such reports on me which the Agency has previously furnished within the two year period for employment requests, and one year for other purposes preceding my request
(California three years). I hereby consent to Company obtaining the above information from such Agencies. I understand that I can dispute, at any time, any information that is inaccurate in any type of report with the Agency by contacting the Agency directly. I may view the Agency's privacy policy at their website. I understand that I can also contact the Company at 1260 State Farm Road, Alexandria, AL, 256-***-**** to request information about the nature of any consumer reports or investigative consumer reports supplied by an Agency.
Agency Contact Information:
HireRight
Attn: Consumers Department
14002 E. 21st Street, Suite 1200
Tulsa, OK 74134
http://www.hireright.com/applicants
iiX
1716 Briarcrest Drive
Suite 200
Bryan, TX 77802
Asurint
Compliance Dept
PO Box 14730
Cleveland, Ohio 44114
Email: ad4rl9@r.postjobfree.com
Tenstreet
120 W. 3rd Street
Tulsa, OK 74103
ad4rl9@r.postjobfree.com
As a California applicant, I understand that I have the right under Section 1786.22 of the California Civil Code to contact the Agency during reasonable hours (9:00 a.m. to 5:00 p.m. (CTZ) Monday through Friday) to obtain all information in Agency's file for my review. I may obtain such information as follows: 1) In person at the Agency's offices, which address is listed above or, if not listed above, 15
obtained by contacting Tenstreet by phone. I can have someone accompany me to the Agency's offices. Agency may require this third party to present reasonable identification. I may be required at the time of such visit to sign an authorization for the Agency to disclose to or discuss Agency's information with this third party; 2) By certified mail, if I have previously provided identification in a written request that my file be sent to me or to a third party identified by me; 3) By telephone, if I have previously provided proper identification in writing to Agency; and 4) Agency has trained personnel to explain any information in my file to me and if the file contains any information that is coded, such will be explained to me. I understand that if the report is provided to an employer in the State of Washington, that I can contact the following office for more information regarding my rights under Washington state law in regard to these reports: State of Washington Attorney General, Consumer Protection Division, 800 5th Ave, Ste. 2000, Seattle, Washington 98104-3188, 206-***-****. Printed Name:
Timothy D Creamer
Social Security #:
6284
Signed Date: 03-26-2024
Timothy D Creamer
415 Russell Ln
Weaver, AL 36277
Gender:
16
IMPORTANT DISCLOSURE
REGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with Trantham Services, Inc. ("Prospective Employer"), Prospective Employer, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA).
When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report. When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act. Neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication.
Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report. The Prospective Employer cannot obtain background reports from FMCSA without your authorization. AUTHORIZATION
If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below: I authorize Trantham Services, Inc. ("Prospective Employer") to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am authorizing the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee.
I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication. I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear on my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report. I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this Disclosure and Authorization, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above. Printed Name:
Timothy D Creamer
17
Signed Date: 03-26-2024
18
Consent for Limited Queries of the Federal Motor Carrier Safety Administration (FMCSA) Drug and Alcohol Clearinghouse
I hereby provide consent to Trantham Services, Inc. to conduct a limited query of the FMCSA Commercial Driver's License Drug and Alcohol Clearinghouse to determine whether drug or alcohol violation information about me exists in the Clearinghouse. I understand this consent shall remain on file and shall serve as ongoing consent for Trantham Services, Inc. to conduct multiple limited queries of the Clearinghouse at any time during my employment or contract period without asking me for additional consent. I understand that if I refuse to provide consent for Trantham Services, Inc. to conduct a limited query of the Clearinghouse, Trantham Services, Inc. is required to prohibit me from performing safety-sensitive functions, including operating a commercial motor vehicle. I understand that if the limited query conducted by Trantham Services, Inc. indicates that drug or alcohol information exists about me in the Clearinghouse, the FMCSA will not disclose that information to Trantham Services, Inc. unless I give additional specific consent within the Clearinghouse. However, I understand that Trantham Services, Inc. will be required to conduct a full query of the Clearinghouse within 24 hours after a limited query indicates that drug or alcohol information exists and that if I do not grant consent within the Clearinghouse for that full query I will be removed from performing safety-sensitive functions, including operating a commercial motor vehicle.
03-26-2024
Timothy D Creamer Date
19
REQUEST FOR CHECK OF DRIVING RECORD
I hereby authorize you to release the following information to TRANTHAM SERVICES, INC. for the purpose of investigation as required by Section 391.23 of the Federal Motor Carrier Safety Regulations. You are released from any and all liability which may result from furnishing such information.
1. In accordance with the provisions of Section 604 and Section 607 of the Fair Credit Reporting Act, Public Law N. 91-508, I hereby certify that the information requested below will be used for a "Permissible purpose" as defined in the Act and that the information received will be used for no other purpose.
2. I further certify that if the applicant named above is denied employment based upon the Information received, I will identify the source of the report in accordance with Section 615 (a) of the Fair Credit Reporting Act. The following named person has applied with our company for the position of truck driver. As in accordance with Section 391.23 Federal Department of Transportation Regulations please furnish the undersigned with the applicant's driving record for the past three years. Printed Name: Timothy D Creamer
Social Security #: 6284
Signed Date: 03-26-2024
Signed:
20
21
Request/Consent for Information from Previous Employer(s)/Carrier(s) For Alcohol and Controlled Substances Testing Records
And changes in Parts 390 and 391 of the FMCSA
X 03-26-2024
Date
X 6284
Social Security Number
Timothy D Creamer
415 Russell Ln
Weaver, AL 36277
Gender:
X Timothy D Creamer
Print Name (First, MI, Last)
X
Signature
I, the above mentioned signer, hereby authorize Self Employed Hot shot To release and forward in accordance with the following regulation, all known information pertaining to my alcohol and
Contact this candidate