Driver
Resume:
Dependable Highway Express
Los Angeles, CA 90023
**-**-**** **:14:24AM CDT
IntelliApp
Thank you for your interest in Dependable Highway Express. 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 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 Gilbert Ray Cummings
Residence 3 years or longer (If No,
previous addresses shown below)
Yes
Current Address 25190 Maynard Dr.
City, State/Province Zip/Postal Moreno Valley, CA 92553 Country United States
SSN/SIN 8830
Date of Birth
Primary Phone 951-***-****
Cell Phone 909-***-****
Preferred method of contact Cell Phone
Best time to contact you Any
Email *****************@*****.***
Yes, I want to receive information and
communications from Dependable
Highway Express concerning future
opportunities or promotions.
Yes
Yes, I want to receive text messages from
Dependable Highway Express. *By
participating, you consent to receive text
messages sent by an automatic telephone
dialing system. Consent to these terms is
not a condition of hire. You may opt out at
any time by texting STOP to unsubscribe.
Message and Data Rates May Apply.
No
1
Company Questions
GENERAL INFORMATION
What position are you applying for? Local
What location are you applying for? Ontario
Are you legally eligible for employment in
the United States?
Yes
Are you currently employed? No
What date did your last employment end? 08-19-2016 Do you read, write, and speak English? Yes
Have you ever worked for this company
before?
No
Enter start and end dates, location,
position, rate of pay, and reason for
leaving:
Do you have a current TWIC card? Yes
Expiration date: 10-05-2016
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? DHE Company Career Site If 'Driver Referral', 'Placement Agency', or
'Other', please enter name
If "Other", please explain
In case of Emergency, notify (list name,
address, and phone):
Gloria J Powers
3755 Chesapeak Ave # 242
Los Angeles, CA. 90016
PH.323-***-****
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 5 months stakebed 03/1983 to 08/ 1983 Tractor and Semi-Trailer I started Driving 12/2010 still driving Dry Vans, Reefer Trls 48' & 53 " 5 half yrs.
Tractor - Two Trailers I have driven bottom dump trls for 3 mounths 07/2015 to 10/2015
Other none
2
Which safe driving awards do you hold
and from whom?
EDUCATION
List highest grade completed: GED
List last school attended (name, city, and
state):
Crenshaw High Los Angeles,Ca
PERSONAL REFERENCES
List name, address, city, state, phone number, and relationship: First Reference: Anita Jackson
1619 W 69st
Loa Angeles, Ca. 90047
ph. 323-***-****
Second Reference: Demardo Echols
address Las Vegas,NV
PH.702-***-****
Licenses
License Number 953
State/Province CA
Country United States
License Class Class A
License Expiration Date 03-02-2020
Physical Expiration Date 04-04-2018
Current License Yes
Commercial Driver License Yes
Endorsements
Tanker Endorsement Yes
HAZMAT Endorsement Yes
Hazmat Expiration Date 03-03-2020
X Endorsement No
Doubles Triples Endorsement Yes
Other Endorsement No
3
Employment / Unemployment
Unemployment
Start Date 09-2016
End Date 10-2016
Comment was unemployed
Schneider National (Emp & Acc Only)
Company Schneider National (Emp & Acc Only)
Start Date 07-2016
End Date 08-2016
Address 3101 S. Packerland Drive
City, State/Province Zip/Postal Green Bay, WI 54313 Country United States
Phone 800-***-****
Fax 215-***-****
Position Held Local Driver
Reason for leaving? Medical
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 Ca & AZ
Miles driven weekly 2000-2500
Pay Range (cents/mile) 18.00 Hr
Most common truck driven Day Cab
Most common trailer Van
Trailer length 53 feet or more
Con-Way Truckload
Company Con-Way Truckload
4
Start Date 11-2015
End Date 06-2016
Address 3915 SOUTH MENDENHALL ROAD SUI
City, State/Province Zip/Postal Joplin, MO 38115
Country United States
Phone 866-***-****
Fax 417-***-****
Position Held OTR Driver
Reason for leaving? Medical
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 48 States
Miles driven weekly 3000-3500
Pay Range (cents/mile) .37
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Unemployment
Start Date 09-2015
End Date 10-2015
Comment unempolyed
JB Hunt Transport, Inc
Company JB Hunt Transport, Inc
Start Date 06-2015
End Date 08-2015
Address 623 N Bloomington Dr
5
City, State/Province Zip/Postal Lowell, AR 72745
Country United States
Phone 888-***-****
Fax 479-***-****
Position Held OTR Driver
Reason for leaving? Personnel
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 11 western States
Miles driven weekly 2000-2500
Pay Range (cents/mile) .39cpm
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Butler Transport, Inc
Company Butler Transport, Inc
Start Date 01-2015
End Date 06-2015
Address 347 N. James Street
City, State/Province Zip/Postal Kansas City, KS 66118-1140 Country United States
Phone 800-***-****
Fax 913-***-****
Position Held OTR Driver
Reason for leaving? Resigned
Were you terminated/discharged/laid off? No
6
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 48 States
Miles driven weekly 3500+
Pay Range (cents/mile) .32 cpm
Most common truck driven Tractor-Trailer
Most common trailer Reefer Trailer
Trailer length 53 feet or more
Unemployment
Start Date 10-2014
End Date 12-2014
Comment death in family
Majewski Transport
Company Majewski Transport
Start Date 01-2014
End Date 09-2014
Address 2928 Greens RD. Blg A
City, State/Province Zip/Postal Houston, TX 77032
Country United States
Phone 281-***-****
Position Held OTR Driver
Reason for leaving? Personnel
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
7
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 48 States
Miles driven weekly 3500+
Pay Range (cents/mile) .32 cpm
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Interstate Distributor Co.
Company Interstate Distributor Co.
Start Date 06-2013
End Date 01-2014
Address 11707 21st Ave Ct S
City, State/Province Zip/Postal Tacoma, WA 98444
Country United States
Phone 800-***-****
Fax 253-***-****
Position Held OTR Driver
Reason for leaving? Resigned
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 11 western states
Miles driven weekly 2500-3000
8
Pay Range (cents/mile)
Most common truck driven Tractor-Trailer
Most common trailer Reefer Trailer
Trailer length 53 feet or more
Unemployment
Start Date 02-2013
End Date 06-2013
Comment Unemployed
Unemployment
Start Date 03-2013
End Date 05-2013
Comment death in family
GSV Transportation
Company GSV Transportation
Start Date 11-2012
End Date 02-2013
Address 11150 Arrow Route Ste E
City, State/Province Zip/Postal Rancho Cucamonga, CA 91730 Country United States
Phone 909-***-****
Position Held OTR Driver
Reason for leaving? Work was Slow
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 42 States
Miles driven weekly 3500+
9
Pay Range (cents/mile) .37 cpm
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Covenant Transport
Company Covenant Transport
Start Date 08-2012
End Date 11-2012
Address 400 Birmingham
City, State/Province Zip/Postal Chattanooga, TN 37419 Country United States
Phone 423-***-****
Fax 423-***-****
Position Held OTR Driver
Reason for leaving? Death in Family
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 48 States
Miles driven weekly 3500+
Pay Range (cents/mile),32 cpm
Most common truck driven Tractor-Trailer
Most common trailer Reefer Trailer
Trailer length 53 feet or more
Western Express
Company Western Express
Start Date 07-2012
10
End Date 08-2012
Address 7135 Centennial Place
City, State/Province Zip/Postal Nashville, TN 37209 Country United States
Phone 615-***-****
Fax 615-***-****
Position Held OTR Driver
Reason for leaving? Death in Family
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 48 States
Miles driven weekly 3500+
Pay Range (cents/mile) .37 cpm
Most common truck driven Tractor-Trailer
Most common trailer Reefer Trailer
Trailer length 53 feet or more
Wolfe Trucking
Company Wolfe Trucking
Start Date 03-2012
End Date 08-2012
Address 7131 Valjean Ave
City, State/Province Zip/Postal Van Nuys, CA 91406 Country United States
Phone 818-***-****
Fax 818-***-****
Position Held OTR Driver
11
Reason for leaving? Death in Family
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 40 States
Miles driven weekly 3500+
Pay Range (cents/mile) .37 cpm
Most common truck driven Tractor-Trailer
Most common trailer Reefer Trailer
Trailer length 53 feet or more
Staffmark Staffing
Company Staffmark Staffing
Start Date 10-2011
End Date 03-2012
Address 1500 S Milliken Ave STE A
City, State/Province Zip/Postal On Tario, CA 91761 Country United States
Phone 909-***-****
Position Held Forklift Operator
Reason for leaving? Resigned
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?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
12
Regulations while employed/contracted by
this employer/contractor?
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Trailer length
Staff Management Staffing
Company Staff Management Staffing
Start Date 03-2011
End Date 09-2011
Address 7511 Clay Ave
City, State/Province Zip/Postal Huntington Beach, CA 92648 Country United States
Phone 714-***-****
Position Held Forklift Operartor
Reason for leaving? Temp
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?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven
13
Most common trailer
Trailer length
WorkForce Staffing
Company WorkForce Staffing
Start Date 08-2011
End Date 09-2011
Address 1500 S Haven Ave Ste 220
City, State/Province Zip/Postal Ontario, CA 91761
Country United States
Phone 909-***-****
Position Held Local Driver
Reason for leaving? Laid Off
Were you terminated/discharged/laid off? Yes
Termination Explanation This was a temporary passion For Goldstar delivering to schools
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 1000-1500
Pay Range (cents/mile) 13.00 hr.
Most common truck driven Tractor-Trailer
Most common trailer Reefer Trailer
Trailer length 53 feet or more
CR England Truck Driving School
Company CR England Truck Driving School
Start Date 12-2010
End Date 04-2011
14
Address 4701 W 2100 South
City, State/Province Zip/Postal Salt Lake City, UT 84120 Country United States
Phone 800-***-****
Fax 801-***-****
Position Held OTR Driver/ Trainnig
Reason for leaving? Discharged
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 48 States
Miles driven weekly 3500+
Pay Range (cents/mile) .90 cpm
Most common truck driven Tractor-Trailer
Most common trailer Reefer Trailer
Trailer length 53 feet or more
NFI Distribution
Company NFI Distribution
Start Date 09-2010
End Date 12-2010
Address 16047 Mountain Ave
City, State/Province Zip/Postal Chino, CA 91708
Country United States
Phone 909-***-****
Position Held Clamp Forklift Operayor
Reason for leaving? Temp
Were you terminated/discharged/laid off? No
15
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Trailer length
Bradshaw International
Company Bradshaw International
Start Date 07-2009
End Date 08-2010
Address 9409 Buffalo Ave
City, State/Province Zip/Postal Rancho Cucamonga, CA 91730 Country United States
Phone 909-***-****
Position Held Forklift Operator
Reason for leaving? Laid Off
Were you terminated/discharged/laid off? Yes
Termination Explanation Work was slow.
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
16
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Trailer length
Express Employment
Company Express Employment
Start Date 06-2008
End Date 01-2009
Address 14135 Francisqurito Ave
City, State/Province Zip/Postal Baldwin Park, CA 91706 Country United States
Phone 626-***-****
Position Held Forklift Operator
Reason for leaving? Temp
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?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Trailer length
17
Cliffstar Corp
Company Cliffstar Corp
Start Date 01-2007
End Date 01-2008
Address 11751 Pacific Ave
City, State/Province Zip/Postal F0ntana, CA 92337
Country United States
Phone 909-***-****
Position Held Clamp Operator
Reason for leaving? Laid Off
Were you terminated/discharged/laid off? Yes
Termination Explanation problem in service.
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Trailer length
Trucking School
Start Date 12-2010
End Date 02-2011
School CR England
City, State/Province Mirfa Loma, CA
Country United States
18
Phone 801-***-****
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
DOT, and subject to drug and alcohol
testing?
Yes
GPA
Hours of Instruction 100
Border Crossing Yes
Log Books Yes
Federal Motor Carrier Regulations No
Hazardous Materials Yes
Motor Vehicle Record
1. Has any license, permit or privilege ever
been denied, suspended or revoked for
any reason?
Yes
Date 04-2014
Comment Child support
2. Have you ever been convicted of driving
during license suspension or revocation, or
driving without a valid license or an expired
license, or are any charges pending?
No
3. Have you ever been convicted for any
alcohol or controlled substance related
offense while operating a motor vehicle, or
are any charges pending?
No
4. Have you ever been convicted for
possession, sale or transfer of an illegal
substance (including but not limited to,
marijuana, amphetamines, or derivatives
thereof) while on duty, or are any charges
pending?
Yes
Date 01-1987
Comment in 1987 possion
5. Have you ever been convicted of
reckless driving, careless driving or
careless operation of a motor vehicle, or
No
19
are any charges pending?
6. Have you ever 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 in past three years, or have
you ever tested positive or refused to test
on any DOT-mandated drug or alcohol
test?
No
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? Violation Date 01-2014
Charge / Description Speeding
MPH Over Limit: 30+
Violation State/Province CA
In Commercial Vehicle Yes
Fined? Yes
License Suspended?
License Revoked?
Perform Community Service?
Other Penalty?
Fine Amount (if any): $200 - $299
Comments: I was in a 55 mph zone doing 60
Criminal Record
Have you ever been convicted of a crime? Yes
Comment 1987 possion
Do you have any deferred prosecutions? No
Do you have criminal charges pending? No
20
Have you ever pled "guilty" to, been
convicted of, or pled "no contest" to a
felony?
Yes
Comment 1987
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
prosecution deferred in connection with, or
pled "no contest" to a misdemeanor?
No
Federal FCRA Summary of Rights Acknowledgment
By checking this box, I acknowledge that I
have read and understand the Summary of
Rights.
Yes
Disclosure Agreement
I agree with the above language Yes
Drug and Alcohol Release
I agree with the above language Yes
Certification Release
I agree with the above language Yes
PSP Release
I agree with the above language Yes
California Consumer Copy Request
Check this box if you are applying for
employment in California and/or you are a
California resident and, in either case, you
wish to receive a copy of your credit report
or investigative consumer report if one is
obtained or assembled by a Consumer
Reporting Agency (CRA). Pursuant to the
California Civil Code, you may view the file
maintained on you by the CRA. You may
Yes
21
also obtain a copy of this file by submitting
proper identification and paying applicable
costs for such file, if required by law, by
contacting the CRA in person or by mail.
The CRA is required to have personnel
available to explain your file to you and
must explain to you any coded information
appearing in your file. If you appear in
person, a person of your choice may
accompany you, provided that person
furnishes proper identification.
User Requested Copy
User requested a copy to be sent to this
email address
*****************@*****.***.
Yes
By my check of this box, I represent that I
understand and agree to the above and
that I intend to execute this document by
electronic signature in checking this box.
Yes
Signature
Full Name Gilbert Ray Cummings
IP Address 47.149.255.110
Signature Date/Time 10-27-2016 12:14 AM
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: 10-27-2016 12:14 AM
Signed:
22
DISCLOSURE FOR CONSUMER REPORTS
Dependable Highway Express (the "Company") may request from a consumer reporting agency and for employment-related purposes, a "consumer report(s)" (commonly known as "background reports") containing background information about you in connection with your employment or application for employment (including independent contractor or volunteer assignments, as applicable). The background report(s) may contain information concerning your character, general reputation, personal characteristics, mode of living, or credit standing. The types of background information that may be obtained include, but are not limited to: criminal history; litigation history; motor vehicle record and accident history; social security number verification; address and alias history; credit history; verification of your education, employment and earnings history; professional licensing, credential and certification checks; drug/alcohol testing results and history; military service; and other information. Printed Name:
Gilbert Ray Cummings
Social Security #:
8830
Signed Date: 10-27-2016
Gilbert Ray Cummings
25190 Maynard Dr.
Moreno Valley, CA 92553
Gender:
23
AUTHORIZATION FOR CONSUMER REPORTS
I hereby authorize Company to obtain the consumer reports described above about me. Printed Name:
Gilbert Ray Cummings
Social Security #:
8830
Signed Date: 10-27-2016
Gilbert Ray Cummings
25190 Maynard Dr.
Moreno Valley, CA 92553
Gender:
24
IMPORTANT DISCLOSURE
REGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with Dependable Highway Express ("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
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