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United States Truck Driver

Location:
Lake City, FL, 32055
Posted:
November 22, 2023

Contact this candidate

Resume:

Centerline Drivers, LLC.

**** *. ****** **, ***** 340

Santa Ana, CA 92701

844-***-****

**-**-**** *:14:35PM CST

IntelliApp

Thank you for your interest in Centerline Drivers, LLC. 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.

If due to a disability, I am unable to complete the application process, I agree to notify the Company so that we may discuss options for a reasonable accommodation. Active Jobs

Job Name NOV - 2192 - Hot Job - SGWS - Jacksonville, FL Job Title Local Class B CDL Box Truck Driver

Personal Information

Referral Code: jp_indeed

Name Ty Canaday

Residence 3 years or longer (If No,

previous addresses shown below)

No

Current Address 310 Sw Lakeview Ave

City, State/Province Zip/Postal Lake City, FL 32025 Country United States

Addresses Over last 3 years Address 1

310 Sw Lakeview Ave

Lake City, FL 32025

United States

03-2022 to 11-2023

Address 2

15805 sr 121 lot 3

Macclenny, FL 32063

United States

04-1990 to 03-2022

SSN/SIN 6376

Date of Birth

Primary Phone 904-***-****

Cell Phone 904-***-****

1

Preferred method of contact Email

Best time to contact you Any

Email ad1dut@r.postjobfree.com

Cell Phone Provider 904-***-****

Yes, I agree to receive information

concerning future opportunities or

promotions from Centerline Drivers, LLC.

by email or other commercial electronic

communications.

Yes

Would you like to receive communication

from Centerline Drivers, LLC. 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

Centerline Drivers, LLC.'s service provider

receives in real time and logs your text

messages with Centerline Drivers, LLC..

Yes

Company Questions

Ad Number Recruiter

GENERAL INFORMATION

What location are you applying for? FL, Jacksonville If hired, can you present evidence of your

right to work in the U.S.?

Yes

Are you currently employed? No

What date did your last employment end? 11-03-2023 Are you able to perform the essential

functions of the job for which you are

applying, either with or without reasonable

accommodation?

Yes

Please describe the functions that cannot

be performed. (Note: We comply with the

ADA and consider reasonable

accommodation measures that may be

necessary for eligible

applicants/employees to perform essential

functions. Hire may be subject to passing a

medical examination, and skill and/or

agility tests.)

2

Have you ever worked for this company

before?

No

Enter start and end dates, location,

position, and reason for leaving:

Are you a veteran? Yes

Do you have a Hazmat Endorsement? No

Do you have a Tanker Endorsement? Yes

Do you have a Double Endorsement? Yes

Do you have a current TWIC card? No

Expiration date:

Have you ever been known by any other

name?

No

Enter name:

How did you hear about Centerline? Indeed.com

If you chose "Referral" or "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 Since 1088

Tractor and Semi-Trailer Since 1995

Tractor - Two Trailers None

Other Tanker/flatbed less than 6 months

EDUCATION

List highest grade completed: College - 3

List last school attended (name, city, and

state):

FSCJ

EMERGENCY CONTACT

Name: Brandi Harvey

Phone Number: 386-***-****

Google Tracking

3

Licenses

List all driver licenses that you have held in the past License Number 390

Licensing Authority FL

Country United States

License Class Class A

Original Issue Date

License Expiration Date 04-19-2028

DOT Medical Card Expiration Date 04-30-2020

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

Envirowaste Services

PLEASE DO NOT CONTACT

Company Envirowaste Services

Start Date 11-2023

End Date 11-2023

Address

City, State/Province Zip/Postal Orlando, FL

Country United States

Phone 407-***-****

Fax 877-***-****

Position Held Driver

Reason for leaving? Need better paying job

Were you terminated/discharged/laid off? No

Is this your current employer? Yes

No

4

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 North Florida

Miles driven weekly 500-1000

Most common truck driven Class B Vehicle

Most common trailer Other

Trailer length 31 feet or less

Pettyone

PLEASE DO NOT CONTACT

Company Pettyone

Start Date 01-2023

End Date 10-2023

Address 900 canal

City, State/Province Zip/Postal Jacksonville, FL 32209 Country United States

Phone 904-***-****

Position Held Linehaul driver

Reason for leaving? Transit time and lack of work

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?

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

Yes

5

subject to drug and alcohol testing?

Areas Driven Jacksonville to Tampa

Miles driven weekly 2000-2500

Most common truck driven Tractor-Trailer

Most common trailer Van

Trailer length 53 feet or more

Petty One LLC

PLEASE DO NOT CONTACT

Company Petty One LLC

Start Date 08-2020

End Date 12-2022

Address 900 Canal Street

City, State/Province Zip/Postal Jacksonville, FL 32209 Country United States

Phone 904-***-****

Position Held Linehaul driver

Reason for leaving? Looking for better pay job with benefits Were you terminated/discharged/laid off? No

Is this your current employer? Yes

May we contact this employer at this time? No

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 Florida

Miles driven weekly 2000-2500

Most common truck driven Tractor-Trailer

Most common trailer Van

Trailer length 53 feet or more

Pritchett Trucking Inc.

Company Pritchett Trucking Inc.

6

Start Date 07-2020

End Date 08-2020

Address 1050 SE 6th Street

City, State/Province Zip/Postal Lake Butler, FL 32054 Country United States

Phone 386-***-****

Fax 386-***-****

Position Held Driver

Reason for leaving? Looking for better pay

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 1500-2000

Most common truck driven Tractor-Trailer

Most common trailer Other

Trailer length 53 feet or more

Pritchett Trucking Inc.

Company Pritchett Trucking Inc.

Start Date 07-2020

End Date 07-2020

Address 1050 SE 6th Street

City, State/Province Zip/Postal Lake Butler, FL 32054 Country United States

Phone 386-***-****

Fax 386-***-****

Position Held

7

Reason for leaving? Looking for something with different hours 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 1500-2000

Most common truck driven Tractor-Trailer

Most common trailer Other

Trailer length 53 feet or more

MPW Industrial Services

Company MPW Industrial Services

Start Date 06-2020

End Date 06-2020

Address 9711 Lancaster Rd SE

City, State/Province Zip/Postal Hebron, OH 43025

Country United States

Phone 740-***-****

Fax 614-***-****

Position Held Driver

Reason for leaving? Looking for full time driving position 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

Yes

8

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 Other

Trailer length 53 feet or more

Unemployment

Start Date 05-2020

End Date 05-2020

Comment Had surgery

Unemployment

Start Date 02-2020

End Date 04-2020

Comment Had to have surgery before I resigned my

position.

Baker Salvage

Company Baker Salvage

Start Date 01-2014

End Date 02-2020

Address 7182 E. Mt. Vernon St.

City, State/Province Zip/Postal Glen St.mary, FL 32063 Country United States

Phone 904-***-****

Position Held Driver

Reason for leaving? Downsizing

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

9

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 2000-2500

Most common truck driven Tractor-Trailer

Most common trailer Van

Trailer length 53 feet or more

TransForce, Inc.

Company TransForce, Inc.

Start Date 03-2012

End Date 01-2014

Address Blanding Blvd Orange Park Fl

City, State/Province Zip/Postal Alexandria, VA

Country United States

Phone

Position Held Driver

Reason for leaving? Took job closer to home

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 2000-2500

Most common truck driven Tractor-Trailer

Most common trailer Van

Trailer length 53 feet or more

10

Crews Logistics

Company Crews Logistics

Start Date 01-2009

End Date 02-2012

Address North Lowder Street

City, State/Province Zip/Postal Macclenny, FL 32063 Country United States

Phone 904-***-****

Position Held Driver

Reason for leaving? Company went under

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 2000-2500

Most common truck driven Tractor-Trailer

Most common trailer Van

Trailer length 53 feet or more

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)]

Yes

Please provide additional detail, including the dates of the suspension(s)/revocation(s): Dot physical not attached was unaware

11

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

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

·

No

12

Vehicle Accident Record

Were you involved in any accidents/incidents with any vehicle in the last 3 years (even if not at fault)?

Type of Accident / Incident Non-Injury

Date of Accident / Incident 12-2015

Hazmat Accident / Incident No

Was the vehicle towed away? No

City

State/Province NC

Were you in a commercial vehicle? Yes

If yes, was this a Department of

Transportation recordable accident?

Yes

Were you at fault? Yes

Were you ticketed? Yes

Description slow speed coming to a stop at stop sign behind a vehicle lightly rearended as driver

stopped short.

Traffic Convictions \ Violations

Have you had any moving violations or traffic convictions in the past 3 years? Violation Date 12-2015

Charge / Description Other

Violation State/Province NC

In Commercial Vehicle Yes

Fined? Yes

License Suspended?

License Revoked?

Perform Community Service?

Other Penalty?

Fine Amount (if any): 100 - $199

Comments: Had fender bender unsurecwhat ticket said no injuries

13

Signature

Full Name Ty Canaday

IP Address 2601:343:c200:45

Signature Date/Time 11-08-2023 5:14 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. 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 safety performance history as required by 49 CFR 391.23(d) and (e). I understand that 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 the corrected information to the prospective employer; and

·

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

·

Signed Date: 11-08-2023 5:14 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

CALIFORNIA DISCLOSURE REGARDING BACKGROUND CHECKS DOCUMENT By checking the box, I 1) agree to use an

electronic signature to demonstrate my

consent, 2) agree that an electronic

signature is as legally binding as an ink

signature, and 3) acknowledge that I have

Yes

14

read and understood this California

Disclosure Regarding Background Checks

document.

Massachusetts Criminal Policy and Record Correction Acknowledgment By checking the box, I (a) acknowledge

that I have read and understand the

Company's Massachusetts Criminal

Record Policy and Information Concerning

the Process in Correcting a Criminal

record and have also been given the

opportunity copy/print both, and (b) agree

to use an electronic signature to

demonstrate my consent. An electronic

signature is as legally binding as an ink

signature.

Yes

New Jersey Summary of Rights Acknowledgment

By checking the box, I (a) acknowledge

that I have read and understand the

Summary of Rights Under New Jersey's

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 acknowledgment. An electronic

signature is as legally binding as an ink

signature.

Yes

New York State Article 23-A Notice

By checking the box, I (a) acknowledge

that I have read and understand the New

York State Correction Law Article 23-A and

have been given the opportunity to

copy/print it and (b) agree to use an

electronic signature to demonstrate my

acknowledgment. An electronic signature

is as legally binding as an ink signature.

Yes

Washington Summary of Rights Acknowledgment

By checking the box, I (a) acknowledge

that I have read and understand the

Summary of Rights Under Washington's

Fair Credit Reporting Act and have been

given the opportunity to copy/print the

Summary of Rights and (b) agree to use

Yes

15

an electronic signature to demonstrate my

acknowledgment. An electronic signature

is as legally binding as an ink signature.

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

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

Yes

16

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.

Summary of Rights Under 15 U.S.C. Section 1681m(a) By checking this box, I represent that I

understand and agree to the above

language.

Yes

NYC Authorization

By checking this box, I represent that I

understand and agree to the above

language.

Yes

NV Background Disclosure-Authorization

By checking this box, I represent that I

understand and agree to the above

language.

Yes

MD Background Disclosure-Authorization

By checking this box, I represent that I

understand and agree to the above

language.

Yes

NH Background Disclosure-Authorization

By checking this box, I represent that I

understand and agree to the above

language.

Yes

User Requested Copy

User requested a copy to be sent to this

email address ad1dut@r.postjobfree.com.

Yes

17

Centerline (the "Company") may request, for lawful employment purposes, background information about you from a consumer reporting agency in connection with your employment or application for employment (including independent contractor assignments, as applicable). This background information may be obtained in the form of consumer reports and/or investigative consumer reports (commonly known as "background reports"). An "investigative consumer report" is a background report that includes information from personal interviews (except in California, where that term includes background reports with or without information obtained from personal interviews), the most common form of which is checking personal or professional references. These background reports may be obtained at any time after receipt of your authorization and, if you are hired or engaged by the Company, throughout your employment or your contract period, as allowed by law.

The background report may contain information concerning your character, general reputation, personal characteristics, and mode of living. The types of information that may be obtained include, but are not limited to: employment history

(e.g., dates of employment, final salary information, performance-related information, reasons for departure, etc.); personal and professional reference checks; and other information bearing on your character, general reputation, personal characteristics, and mode of living.

This information may be obtained from private and public record sources, including, as appropriate: government agencies and courthouses; educational institutions; former employers; and, for investigative consumer reports, personal interviews with sources such as neighbors, friends, former employers and associates; and other information sources provided as references. The Company is not intending to collect, and will not be requesting, any information bearing on your credit worthiness, credit standing, or credit capacity, unless it otherwise notifies you prior thereto in writing. You may request more information about the nature and scope of an investigative consumer report, if any, by contacting the Company.

A summary of your rights under the Fair Credit Reporting Act is also being provided to you. Printed Name:

Ty Canaday

Social Security #:

6376

Signed Date: 11-08-2023

Ty Canaday

310 Sw Lakeview Ave

Lake City, FL 32025

904-***-****

Gender:

DISCLOSURE REGARDING BACKGROUND INVESTIGATION 18

ACKNOWLEDGMENT AND AUTHORIZATION

I have carefully read and understand the Disclosure Regarding Background Investigation and the attached summary of rights under the Fair Credit Reporting Act. By my signature below, I consent to preparation of background reports by a consumer reporting agency such as Asurint and/or HireRight, and to the release of such background reports to the Company and its designated representatives and agents, for the purpose of assisting the Company in making a determination as to my eligibility for employment, promotion, retention or for other lawful employment purposes. I understand that if the Company hires me, my consent will apply, and the Company may, as allowed by law, obtain additional background reports pertaining to me, without asking for my authorization again, throughout my employment or contract period from Asurint, HireRight and/or other consumer reporting agencies. I also understand that nothing herein shall be construed as an offer of employment. By my signature below, I certify the information I provided on and in connection with this form is true, accurate, and complete. I agree that this form in original, faxed, photocopied or electronic (including electronically signed) form, will be valid for any background reports that may be requested by or on behalf of the Company. Printed Name:

Ty Canaday

Social Security #:

6376

Signed Date: 11-08-2023

Ty Canaday

310 Sw Lakeview Ave

Lake City, FL 32025

904-***-****

Gender:

DISCLOSURE REGARDING BACKGROUND INVESTIGATION 19

IMPORTANT DISCLOSURE

REGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with Centerline Drivers, LLC. ("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 Centerline Drivers, LLC. ("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



Contact this candidate