Decker Truck Line, Inc.
**-**-**** *:25:51AM CDT
IntelliApp
Thank you for your interest in:
Decker Truck Line, Inc.
Fort Dodge, IA 50501
To apply for a driving position, please complete our online application. 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
Referral Code: DriveDecker.com
Name Irving J. Maldonado, Sr.
Residence 3 years or longer (If No,
previous addresses shown below)
Yes
Current Address 3610 Trent Avenue
City, State/Province Zip/Postal Cleveland, OH 44109 Country United States
SSN/SIN 2299
Date of Birth
Primary Phone 216-***-****
Cell Phone 216-***-****
Preferred method of contact Email
Best time to contact you Any
Email ac8wgk@r.postjobfree.com
Yes, I want to receive information and
communications from Decker Truck Line,
Inc. concerning future opportunities or
promotions.
Yes
Yes, I want to receive text messages from
Decker Truck Line, Inc.. *By participating,
you consent to receive text messages sent
by an automatic telephone dialing system.
Consent to these terms is not a condition
Yes
1
of hire. You may opt out at any time by
texting STOP to unsubscribe. Message
and Data Rates May Apply.
Company Questions
GENERAL INFORMATION
What company are you applying to? Decker Truck Lines What position are you applying for? Current Student What location are you applying for? All The Above
Did you speak with a recruiter regarding a
position?
None
How many years of OTR driving
experience do you have?
15
Is there any reason you might be unable to
perform the functions of the job for which
you have applied?
No
Are you legally eligible for employment in
the United States?
Yes
Are you a United States military veteran? No
Are you currently employed? No
What date did your last employment end? 5/27/2018
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:
What is your full legal name? IRVING J. MALDONADO
Have you ever been known by any other
name?
No
Enter name:
When are you available to start? Undecided
How did you hear about us? Indeed.com
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 2 yrs.
Tractor and Semi-Trailer 1 yr.
2
Tractor - Two Trailers O
Other 0
Which safe driving awards do you hold
and from whom?
National Safety Council DDC-Professional
Truck Driver- Certificate of Completion Nov
11,1995. Greater Cleveland Safety Council
1375 Euclid Ave. Room 310 Cleveland
Ohio 44115 216-***-**** Security
Control No. 175973.
EQUIPMENT (OWNER/OPERATORS ONLY)
Equipment Description (Tractor):
Type:
Year:
Make:
Model:
Color:
VIN:
Weight
Mileage
Fifth Wheel Height
EDUCATION
List highest grade completed:
List last school attended (name, city, and
state):
Cuyahoga Community College metro
campus. Cleveland, Ohio
Licenses
License Number 532
State/Province OH
Country United States
License Class Class A
License Expiration Date 09-16-1946
Physical Expiration Date 09-16-2020
Current License Yes
Commercial Driver License Yes
Endorsements
Tanker Endorsement Yes
HAZMAT Endorsement No
3
X Endorsement No
Doubles Triples Endorsement Yes
Other Endorsement Yes
Employment / Unemployment
Unemployment
Start Date 07-2018
End Date 07-2018
Comment I was not working at this time. I was living of my Retirement Pension
Unemployment
Start Date 06-2018
End Date 06-2018
Comment I was working for Apex Transit Solutions at 3950 Prospect Ave. CLEVELAND,OH
44115 phone#:216-***-****
Lakefront Lines Coach USA
Company Lakefront Lines Coach USA
Start Date 04-2018
End Date 05-2018
Address '13315 Broopark Rd.
City, State/Province Zip/Postal Brookpark, OH 44142 Country United States
Phone 216-***-****
Position Held Motor Coach Operator Trainee
Reason for leaving? I wasn't able to grasp their driving techniques.
Were you terminated/discharged/laid off? Yes
Termination Explanation I was Lay-Off because, I couldn't comprehend everything that's involved in
driving Motor Coach.
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
Yes
Yes
4
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?
Yes
Areas Driven CLEVELAND, TOLEDO, OHIO
Miles driven weekly 0-500
Most common truck driven Other
Most common trailer Other
Trailer length 45 to 52 feet
Paschall Truck Line inc.
Company Paschall Truck Line inc.
Start Date 03-2018
End Date 04-2018
Address 111 CS-1000
City, State/Province Zip/Postal Murray, KY 42071
Country United States
Phone 844-***-****
Position Held Trainee
Reason for leaving? They refuse to trained me
Were you terminated/discharged/laid off? Yes
Termination Explanation I was told by the trainer and managers that they didn't have the time to trained me. So,
I was send home.
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 Murray, Kentucky
Miles driven weekly 0-500
Most common truck driven Conventional Tractor
Most common trailer Van
Trailer length 53 feet or more
Swift Transportation inc.
Company Swift Transportation inc.
Start Date 04-2018
End Date 04-2018
Address 4141 Parkwest Drive
City, State/Province Zip/Postal Columbus, OH 43228 Country United States
Phone 614-***-****
Position Held Trainee
Reason for leaving? I was send home because,I didn't have my Driving Glasses.
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 COLUMBUS, Ohio
Miles driven weekly 0-500
Most common truck driven Conventional Tractor
Most common trailer Van
Trailer length 53 feet or more
Cr England
Company Cr England
Start Date 02-2018
6
End Date 03-2018
Address 321 Tech Drive
City, State/Province Zip/Postal Burns Harbor, IN 46304 Country United States
Phone 866-***-****
Position Held Orientation
Reason for leaving? Medical Reason
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 Burns Harbor, Indiana
Miles driven weekly 0-500
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Unemployment
Start Date 09-2015
End Date 01-2018
Comment I was unemployed at this time. I was living of my Retirement Pension.
Unemployment
Start Date 07-2015
End Date 08-2015
Comment I was not employed at this time. I was
home living off my Retirement Pension.
Unemployment
Start Date 07-2014
End Date 09-2014
7
Comment I was working for Cr England at 321 Tech
Dr. Burns Harbor IN 46305 Phone:
Trucking School
Start Date 10-1995
End Date 12-1995
School Hambrick Truck Driving Shool
City, State/Province Medina, OH
Country United States
Phone 216-***-****
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 85
Hours of Instruction 120
Border Crossing Yes
Log Books Yes
Federal Motor Carrier Regulations Yes
Hazardous Materials Yes
Trucking School
Start Date 03-1998
End Date 05-1998
School Hambrick Truck Driving School
City, State/Province Medina, OH
Country United States
Phone 216-***-****
Did you graduate? Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Yes
8
Regulations while attending this truck
school?
Did you perform any safety sensitive
functions at this truck school, regulated by
DOT, and subject to drug and alcohol
testing?
Yes
GPA 85
Hours of Instruction 200
Border Crossing Yes
Log Books Yes
Federal Motor Carrier Regulations Yes
Hazardous Materials Yes
Motor Vehicle Record
1. Has any license, permit or privilege ever
been denied, suspended or revoked for
any reason?
No
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?
No
5. Have you ever been convicted of
reckless driving, careless driving or
careless operation of a motor vehicle, or
are any charges pending?
No
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
9
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 traffic convictions and forfeitures for the past 3 years? (Include both pending charges and convictions; other than parking 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 On 8/13/1998 I was charged with
Felonious Assault.On 10/22/1998 I
pleaded guilty to Attempted Aggravated
Assault.On 12/11/1998 I was sentenced to
2 yrs.probation.I was order to pay court
cost and Supervision fees.I was never
incarcerated. PROBATION OFFICER:
JOSEPH KEPPLER 216-***-****.
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 Please read the above information which
applies to this section.Thank You.
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
Yes
10
By checking this box, I acknowledge that I
have read and understand the Summary of
Rights.
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
User Requested Copy
User requested a copy to be sent to this
email address ac8wgk@r.postjobfree.com.
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 Irving J. Maldonado, Sr.
IP Address 65.185.171.61
Signature Date/Time 07-12-2018 6:25 AM
By clicking next, I agree that my electronic signature will be applied to my application. 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: 07-12-2018 6:25 AM
Signed:
11
DISCLOSURE AND RELEASE
In connection with your employment or application for employment (including contract for services) through Decker Truck Line, Inc. consumer reports
(Investigative Consumer Reports in California) may be requested from HireRight (formerly USIS Commercial Services). These reports may include the following types of information: names and dates of previous employers, reasons for termination of employment, work experience, accidents, academic history, professional credentials and drug/alcohol use. Such reports may contain public record information concerning your driving record, workers' compensation claims, credit, bankruptcy proceedings, criminal records, etc. from federal, state and other agencies that maintain such records; as well as information from HireRight concerning previous driving record requests made by others from such state agencies and state provided driving records.
We also will obtain driving/accident and safety inspection history records maintained by the Federal Motor Carrier Safety Administration ("FMCSA"). You have the right to make a request to HireRight, upon proper identification, to request the nature and substance of all information in its files on you at the time of your request, including the explaining of any coded information, the sources of information and the recipients of any reports on you that HireRight has previously furnished within the past two year period preceding your request (3 years in California). HireRight may be contacted by mail at P.O. Box 33181, Tulsa, OK 74153 or by telephone at 800-***-****. You may also bring a third party with you to view the information at the HireRight offices if this person provides proper identification. Information about HireRight's privacy practices is available at www.hireright.com/Privacy-Policy.aspx.
I AUTHORIZE, WITHOUT RESERVATION, HIRERIGHT, FMCSA AND ANY OTHER PARTY OR AGENCY CONTACTED BY HIRERIGHT TO FURNISH THE ABOVE MENTIONED INFORMATION. THIS AUTHORIZATION DOES NOT APPLY TO DRUG AND ALCOHOL INFORMATION CONTAINED UNDER PART I.
I hereby consent to your obtaining the above information from HireRight, and I agree that such information which HireRight has or obtains in my employment history (not DOT drug and alcohol information without a specific consent by me) with you if I am hired, will be supplied by HireRight to other companies which subscribe to HireRight. I hereby authorize procurement of consumer reports as set forth above. If hired or contracted, this authorization for reports covered by this release only shall remain on file and shall serve as an ongoing authorization for you to procure consumer reports at any time during my employment or contract period. I consent to you obtaining the above information from FMCSA. I understand that the FMCSA maintains sole control over that data and you cannot change or alter such information. If I dispute any information maintained by FMCSA, I must personally contact the FMCSA by accessing the DataQs System at: https://dataqs.fmcsa.dot.gov.
Printed Name:
IRVING J. Maldonado, Sr.
Social Security #:
2299
Signed Date: 07-12-2018
IRVING J. Maldonado, Sr.
3610 Trent Avenue
Cleveland, OH 44109
Gender:
12
IMPORTANT DISCLOSURE
REGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with Decker Truck Line, 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 Decker Truck Line, 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:
IRVING J. Maldonado, Sr.
Signed Date: 07-12-2018
13
TO BE READ AND SIGNED BY APPLICANT
I certify that I personally completed this application and that all of the information is true and correct. I authorize Decker Truck Line, Inc. or their agents to make investigations, inquiries and to obtain any and all information and/or reports regarding my personal, employment, financial or medical history in accordance with state and federal laws in order to arrive 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.
I have the right to review information provided by previous employers, have errors in the information corrected by previous employers and for those previous employers to re-send any corrected information to Decker Truck Line, Inc. I have the right to have a rebuttal statement attached to alleged erroneous information, if the previous employer (s) and I cannot agree on accuracy. I understand that information I provide regarding current and/or previous employers may be used, and those employer (s) will be contacted, for the purpose of investigating my employment history and performance, safety performance history, and drug & alcohol testing records as required by 49 CFR 391.23(d) and (e).
I understand that false or misleading information in this application will be considered an act of dishonesty and disqualify me from further consideration and that I am subject to immediate termination if this becomes known after employment has begun. Applicants not offered employment will not be provided any detail, as company policy does not allow disclosure of this information. I understand the policy not to provide any reasons or details if employment/lease is not offered, and I agree to be bound by the policy. When an employment decision is based in whole or in part upon a consumer report, I will be notified in compliance with the Fair Credit Reporting Act. By my signature below, I certify that I am a bona fide applicant for employment/lease and this application is being submitted solely for the purpose of seeking employment/lease and for no other purpose. I understand and agree that nothing contained in this application, or conveyed during any interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be "at will" and without fixed term, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or the Company. No promises regarding employment have been made to me, and I understand that no such promise, or guarantee is binding upon the Company unless made in writing. If I am offered employment I agree to submit to a medical examination and drug test before starting work. I consent to such examinations and tests, and I request that the examining doctor disclose to the Company the results of the examination, which results shall remain confidential and segregated from my personnel file. I understand that my employment or continued employment, to the extent permitted by law, is contingent upon satisfactory medical examinations and drug test, and if I am hired a condition of my employment will be that I abide by the Company's Drug and Alcohol Policy. I understand that I am required to abide by all rules and regulations of the Company. Printed Name: IRVING J. Maldonado, Sr.
Social Security #: 2299
Signed Date: 07-12-2018
Signed:
END OF APPLICATION
14
15
CONSUMER REPORT AND INVESTIGATIVE CONSUMER REPORT DISCLOSURE
(FOR EMPLOYMENT PURPOSES)
In connection with your employment or application for employment (including contract for services) and in accordance with applicable laws, Decker Truck Line, Inc. (the Company), may obtain or assemble consumer reports and/or investigative consumer reports
(collectively, "Reports") which may include information about you related to: previous employment (including employers, dates of employment, salary information, reasons for termination, etc.), accident history, academic history, verification of references and other information supplied by applicant, professional credentials, drug & alcohol use in violation of law and/or company policy, driving record, workers compensation claims, credit history, creditworthiness, credit capacity, bankruptcy filings, criminal history records, information about your character, general reputation, personal characteristics mode of living (collectively, "Information"). Information may be obtained from Background Screening Agencies (the Agency), government agencies, educational institutions, personal references, personal interviews and other information suppliers (collectively, "Suppliers"). Upon providing proper identification and complying with any applicable legal requirements, you have the right to request the nature and substance of all information in the Agency's files pertaining to you at the time of your request, including but not limited to: (i) whether any Reports have been provided by the Agency to other parties; (ii) identification of any Suppliers utilized by the Company in compiling such Reports; and (iii) identification of any recipients of Reports furnished by the Agency within the two (2) year period preceding your request. Contact the Company for the Agency contact information. 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 the Agency, contact your recruiter. Pursuant to the California Civil Code, you may view the file maintained on you by the Agency during normal business hours. You may 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 Agency in person or by mail. The Agency 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 this person furnishes proper identification.
If you are applying for employment in Oklahoma and/or you are an Oklahoma resident and, in either case, you wish to receive a copy of your consumer report if one is obtained or assembled by the Agency, contact your recruiter. If you are applying for employment in Minnesota and/or you are a Minnesota resident and, in either case, you wish to receive a copy of your consumer report if one is obtained or assembled by the Agency, contact your recruiter. Printed Name: IRVING J. Maldonado, Sr.
Social Security #: 2299
Signed Date: 07-12-2018
Signed:
16
AUTHORIZATION FOR RELEASE OF INFORMATION (FOR EMPLOYMENT PURPOSES)
I hereby authorize any Agency the Company contacts to receive information and disclose such information to the Company for the purpose of making a determination as to my eligibility for employment, promotion, retention or other lawful purpose. If hired or contracted, I authorize the Company to retain this document on file to act as ongoing authorization for the procurement and possession of Reports at any time during my employment or contract period. I fully release the Agency and Suppliers from all claims of damages related to the investigation of my background and provision of information as set forth in this disclosure and authorization. I agree that information in the Agency's possession and my employment history with the Company if I am hired may be supplied by the Agency to other Agency customers for legally permissible purposes.
By signing below, I certify that: (i) all information provided