SCHENKER (IC)
Van Buren, AR 72957
**-**-**** *:24:41AM CDT
Intelliapp - IC
Thank you for your interest in SCHENKER (IC). 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
Referral Code: CDLJobNow_Owner_Operator
Name Asnake T Negash, Jr.
Residence 3 years or longer (If No,
previous addresses shown below)
No
Current Address 919 Gabel Street
City, State/Province Zip/Postal Silver Spring, MD 20901 Country United States
Addresses Over last 3 years Address 1
919 Gabel street
Silver Spring, MD 20901
United States
10-2023 to 10-2023
Address 2
3416 Crane hill CT
Orange Park, FL 32065
United States
04-2016 to 10-2023
SSN/SIN 4544
Date of Birth
Primary Phone 904-***-****
Cell Phone 904-***-****
Preferred method of contact Text Message
Best time to contact you Any
Email ad0hub@r.postjobfree.com
How did you hear about us? Internet - DriverJobNetwork.com 1
Yes, I agree to receive information
concerning future opportunities or
promotions from SCHENKER (IC) by email
or other commercial electronic
communications.
Yes
Would you like to receive communication
from SCHENKER (IC) via text message?
By participating, you consent to receive
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 to
unsubscribe. You also agree that
SCHENKER (IC)'s service provider
receives in real time and logs your text
messages with SCHENKER (IC).
Yes
Company Questions
GENERAL INFORMATION
What position are you applying for? Lease Purchase Name of your Recruiter, if you have one?
Have you ever operated under your own
authority?
Yes
Please list your company name and TPA. Yafet Transportation LLC MC # 091133
DOT # 3127154
Do you read, write, and speak English? Yes
How did you hear about us? Job Board
Driver Referral
Military Veteran? No
DRIVING EXPERIENCE
How much Class A experience do you
have?
7 years
How much experience do you have
operating as an Independent Contractor?
6 to 11 months
EQUIPMENT (INDEPENDENT CONTRACTORS ONLY)
Will you be bringing equipment? No
Name of Leasing/Purchasing Company:
Phone Number:
Equipment Description (Tractor):
2
Type:
Year:
Make:
Model:
Color:
VIN:
Federal Tax Identification Number (EIN): 825041214 If applicable, do you currently have
required approval to change Carriers?
Yes
Licenses
List all driver's license and/or permits held by you in the past 5 years. License Number 070
Licensing Authority FL
Country United States
License Class Class A
License Expiration Date 01-07-2024
DOT Medical Card Expiration Date 12-04-2017
Current License Yes
Commercial Driver License Yes
Endorsements None
Restrictions
No Night Driving No
Corrective Lenses No
No Air Brakes No
No Manual Transmission No
Other Restriction No
Employment / Unemployment
Unemployment
Start Date 08-2023
End Date 10-2023
Comment Vacation back home
Yafet Transportation LLC
3
Company Yafet Transportation LLC
Start Date 02-2023
End Date 07-2023
Address 3416 Crane hill CT
City, State/Province Zip/Postal Orange Park, FL 32065 Country United States
Phone 904-***-****
Position Held Owner Operator ( my own company )
Reason for leaving? My Truck broke down ( Expensive Mentenance
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?
No
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
No
Areas Driven 48 State
Miles driven weekly 2500-3000
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Unemployment
Start Date 12-2022
End Date 01-2023
Comment I am not moving at this period
Unemployment
Start Date 07-2022
End Date 11-2022
Comment
Yafet Transportation LLC
4
Company Yafet Transportation LLC
Start Date 01-2019
End Date 06-2022
Address 3416 Crane hill CT
City, State/Province Zip/Postal Orange Park, FL 32065 Country United States
Phone 904-***-****
Position Held Owner Operater
Reason for leaving? Market
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?
No
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
No
Areas Driven
Miles driven weekly
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Yafet Transportation LLC
Company Yafet Transportation LLC
Start Date 05-2018
End Date 07-2019
Address 3416 Crane hill CT
City, State/Province Zip/Postal Orange Park, FL 32065 Country United States
Phone 904-***-****
Position Held Owner, Driver
Reason for leaving? Market
5
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?
No
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
No
Areas Driven
Miles driven weekly
Most common truck driven Tractor - Trailer
Most common trailer Van
Trailer length 53 feet or more
ENG Transportation, Inc.
Company ENG Transportation, Inc.
Start Date 02-2018
End Date 04-2018
Address 12200 Ford Road RD
Address 2 STE 189
City, State/Province Zip/Postal Dallas, TX 75234
Country United States
Phone 972-***-****
Fax 972-***-****
Position Held Driver
Reason for leaving? To get my owen Truck
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
Yes
6
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
Miles driven weekly
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
ENG Transportation, Inc.
Company ENG Transportation, Inc.
Start Date 01-2018
End Date 01-2018
Address 12200 Ford Road RD
Address 2 STE 189
City, State/Province Zip/Postal Dallas, TX 75234
Country United States
Phone 972-***-****
Fax 972-***-****
Position Held Solo Driver
Reason for leaving? Started
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
Most common truck driven Tractor-Trailer
7
Most common trailer Van
Trailer length 53 feet or more
ENG Transportation, Inc.
Company ENG Transportation, Inc.
Start Date 11-2017
End Date 12-2017
Address 12200 Ford Road RD
Address 2 STE 189
City, State/Province Zip/Postal Dallas, TX 75234
Country United States
Phone 972-***-****
Fax 972-***-****
Position Held Team Driver
Reason for leaving? Going Solo
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
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
USA Truck
Company USA Truck
Start Date 10-2017
End Date 11-2017
Address
8
City, State/Province Zip/Postal Van Buren, AR
Country United States
Phone
Position Held
Reason for leaving? good opportunity
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
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Pam Transport (Employment)
Company Pam Transport (Employment)
Start Date 05-2017
End Date 09-2017
Address P.O. Box 188
City, State/Province Zip/Postal Tontitown, AR 72770 Country United States
Phone
Fax 479-***-****
Position Held
Reason for leaving? Good opportunity
Were you terminated/discharged/laid off? No
Is this your current employer? Yes
Yes
9
May we contact this employer at this time?
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
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Unemployment
Start Date 01-2017
End Date 04-2017
Comment
ENG Transportation, Inc.
Company ENG Transportation, Inc.
Start Date 12-2016
End Date 12-2016
Address 12200 Ford Road RD
Address 2 STE 189
City, State/Province Zip/Postal Dallas, TX 75234
Country United States
Phone 972-***-****
Fax 972-***-****
Position Held Team Driver
Reason for leaving? Project was over
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 Yes
10
vehicle?
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
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 45 to 52 feet
Cr England
Company Cr England
Start Date 11-2016
End Date 11-2016
Address
City, State/Province Zip/Postal Salt Lake City, UT Country United States
Phone
Position Held
Reason for leaving? Opportunity
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
Most common truck driven Tractor-Trailer
11
Most common trailer Van
Trailer length 53 feet or more
Unemployment
Start Date 07-2016
End Date 10-2016
Comment
Werner Enterprises (Past Drivers Only)
Company Werner Enterprises (Past Drivers Only)
Start Date 02-2016
End Date 06-2016
Address P.O. Box 45308
City, State/Province Zip/Postal Omaha, NE 68145-0308 Country United States
Phone 800-***-****
Fax 866-***-****
Position Held Truck Driver
Reason for leaving? Need more miles, and asking to make more money.
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
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Unemployment
12
Start Date 01-2016
End Date 01-2016
Comment I was looking, and choose a different
company. Before I make decisions.
Macclenny Bp Inc
Company Macclenny Bp Inc
Start Date 06-2015
End Date 10-2015
Address 257 west Macclenny Ave
Address 2 Macclenny Ave
City, State/Province Zip/Postal Macclenny, FL 32063 Country United States
Phone 951-***-****
Position Held Cashier
Reason for leaving? To start new career
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
Most common truck driven
Most common trailer
Trailer length
Sunshine Food Mart
PLEASE DO NOT CONTACT
Company Sunshine Food Mart
Start Date 01-2014
13
End Date 06-2015
Address 2584 cr 220, Middelburg
Address 2 Middelburg
City, State/Province Zip/Postal Middelburg, FL 32068 Country United States
Phone 904-***-****
Position Held Casheir
Reason for leaving? Out of business
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? No
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
Most common truck driven
Most common trailer
Trailer length
Macclenny Bp Inc.
Company Macclenny Bp Inc.
Start Date 09-2013
End Date 01-2014
Address 257 west Macclenny Ave
Address 2 Macclenny
City, State/Province Zip/Postal Macclenny, FL 32063 Country United States
Phone 951-***-****
Position Held Casheir
Reason for leaving? Good Opportunity
14
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
Most common truck driven
Most common trailer
Trailer length
Sunshine Food Mart
PLEASE DO NOT CONTACT
Company Sunshine Food Mart
Start Date 08-2012
End Date 09-2013
Address 2584 CR 220 Middelburg
Address 2 Middelburg
City, State/Province Zip/Postal Middelburg, FL 32068 Country United States
Phone 904-***-****
Position Held Casheir
Reason for leaving? Good Opportunity
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? No
Did you operate a commercial motor
vehicle?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
15
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
Most common truck driven
Most common trailer
Trailer length
Kiwik way Argyle Inc. Bp Gas station
Company Kiwik way Argyle Inc. Bp Gas station
Start Date 11-2011
End Date 08-2012
Address 116 Oakleaf Pkwy
Address 2 Oakleaf Pkwy
City, State/Province Zip/Postal Orange Park, FL 32065 Country United States
Phone
Position Held Cashier
Reason for leaving? Good opportunity
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
Most common truck driven
Most common trailer
16
Trailer length
Golden Ox Liquor Store
Company Golden Ox Liquor Store
Start Date 05-2011
End Date 11-2011
Address 9542 Argyle Forest Blvd
Address 2 Argyle Forest Blvd
City, State/Province Zip/Postal Jacksonville, FL 32065 Country United States
Phone
Position Held Cashier
Reason for leaving? Good opportunity
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
Most common truck driven
Most common trailer
Trailer length
Alphamed LLC Pharmacy Inc. Palatka Drugs
Company Alphamed LLC Pharmacy Inc. Palatka
Drugs
Start Date 11-2010
End Date 05-2011
Address 4109 Crill Ave
Address 2 Crill Ave
17
City, State/Province Zip/Postal Palatka, FL 32177 Country United States
Phone
Position Held Cashier
Reason for leaving? The Store Sold, for big company 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
Most common truck driven
Most common trailer
Trailer length
Wal - Mart Assosiate Inc.
Company Wal - Mart Assosiate Inc.
Start Date 07-2010
End Date 11-2010
Address 899 Blanding Blvd
Address 2 Blanding Blvd
City, State/Province Zip/Postal Orange Park, FL 32065 Country United States
Phone
Position Held Cart pushier
Reason for leaving? Good opportunity
Were you terminated/discharged/laid off? No
Is this your current employer? No
Yes
18
May we contact this employer at this time?
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
Most common truck driven
Most common trailer
Trailer length
Unemployment
Start Date 04-2007
End Date 06-2010
Comment I was in Haiti, as a refuge . Waiting Visa, to come here.
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]:
No
19
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
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)?
Type of Accident / Incident Non-Injury
Date of Accident / Incident 04-2016
Nature of Accident / Incident
Hazmat Accident / Incident No
Was the vehicle towed away? No
City I don't remember
State/Province KS
Were you in a commercial vehicle? Yes
If yes, was this a Department of
Transportation recordable accident?
No
Were you at fault? Yes
20
Were you ticketed? No
Description That was backing in blind side, just
touched on front grill of the other truck.
And Small cracked, on it .
Traffic Convictions \ Violations
Have you had any moving violations or traffic convictions in the past 5 years? Violation Date 02-2016
Charge / Description Speeding
MPH Over Limit: 10
Violation State/Province AR
In Commercial Vehicle Yes
Fined? Yes
License Suspended?
License Revoked?
Perform Community Service?
Other Penalty?
Fine Amount (if any): 100 - $199
Comments: That was my first week, I was training by Trainer. After that day I don't have any
tickets
Signature
Full Name Asnake T Negash, Jr.
IP Address 2600:387:f:6634:
Signature Date/Time 10-19-2023 8:24 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: 10-19-2023 8:24 AM
Signed:
21
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
Maryland Statement of Rights of the Consumer
By checking the box, I (a) acknowledge
that I have read and understand the
Summary of Rights Under the Fair Credit
Reporting Act and also 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
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
Yes
22
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.
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
Summary of Rights Under 15 U.S.C. Section 1681m(a) By checking the box, I (a) acknowledge
that I have read and understand the
Summary of Rights Under 15 U.S.C.
Section 1681m(a) and have been given
the opportunity to copy/print the 1681m
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
INVESTIGATIVE CONSUMER REPORT DISCLOSURE
By checking this box, I represent that I
understand and agree to the above
Investigative Consumer Report
Disclosure.
Yes
23
User Requested Copy
User requested a copy to be sent to this
email address
ad0hub@r.postjobfree.com.
Yes
24
DISCLOSURE FOR CONSUMER REPORTS
In connection with your employment or owner-operator (independent contractor) application, Schenker, Inc., USA Truck Inc. and/or its subsidiaries, parents, successors, and affiliates may order one or more consumer report(s) (commonly known as "background reports" or "background checks") about you from one or more consumer reporting agencies. If you are hired or engaged as an owner-operator
(independent contractor), additional consumer reports may be obtained in connection with and throughout your employment for employment purposes or for the legitimate business purpose of evaluating you as an owner-operator. To the extent allowed by law, the consumer reports may include information concerning your character, general reputation, personal characteristics, mode of living, drug and alcohol test results, motor vehicle records, driving records, criminal information, public court records, employment history (including names and dates of previous employers, reason for termination of employment, work experience, and accidents), social security number validation, education, licensure, or verification of other information supplied by you. Such reports may be obtained from private and public record sources, including sanctions databases, CDLIS, former employers, public court records, and federal, state, and other government agencies that maintain such records. Printed Name:
Asnake T Negash, Jr.
Social Security #:
4544
Signed Date: 10-19-2023
Asnake T Negash, Jr.
919 Gabel Street
Silver Spring, MD 20901
Gender:
25
AUTHORIZATION FOR CONSUMER REPORTS
I authorize Schenker, Inc., USA Truck Inc. and/or its subsidiaries, parents, successors, and affiliates to obtain one or more consumer report(s) or investigative consumer report(s) about me. If hired or engaged as an owner-operator (independent contractor), I understand this authorization shall remain on file and shall serve as ongoing authorization for additional consumer reports or investigative consumer reports to be obtained from any consumer reporting agency at any time during my employment or contract period without asking me for authorization again.
Printed Name:
Asnake T Negash, Jr.
Social Security #:
4544
Signed Date: 10-19-2023
Asnake T Negash, Jr.
919 Gabel Street
Silver Spring, MD 20901
Gender:
26
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