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United States Qualified Applicants

Location:
Fayetteville, NC
Salary:
Negotiate That
Posted:
February 05, 2024

Contact this candidate

Resume:

EW Wylie

**** *** ****** **

West Fargo, ND *****

800-***-****

**-**-**** **:29:54PM CDT

IntelliApp

Thank you for your interest in EW Wylie. 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: leadflexppc

Name Johnny M Shelly, Sr.

Residence 3 years or longer (If No,

previous addresses shown below)

Yes

Address 326 Longhill Dr

City, State/Province Zip/Postal Fayetteille, NC 28311 Country United States

SSN/SIN 0880

Date of Birth

Primary Phone 910-***-****

Cell Phone 910-***-****

Preferred method of contact Cell Phone

Best time to contact you Any

Email ad3d0t@r.postjobfree.com

Company Questions

GENERAL INFORMATION

What position are you applying for? Lease Purchase What location are you applying for? Sanford, NC

Are you a U.S. citizen? Yes

Are you legally eligible for employment in

the United States?

Yes

Are you currently employed? No

1

What date did your last employment end? july 2012

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? No

Expiration date:

Do you have a current Passport/Pass

card?

No

Expiration date:

Please enter the names of any relatives

employed here:

Have you ever been known by any other

name?

No

Enter name:

How did you hear about EW Wylie? Internet

How did you hear about EW Wylie? Internet

How did you hear about EW Wylie? Internet

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 van 200*-****-**,000

Tractor and Semi-Trailer reefer,van, flatbed 200*-****-***,000 Tractor - Two Trailers none

Other Special Military Hauling

Which safe driving awards do you hold and

from whom?

3 year safety driver award Marten

Transport

EQUIPMENT (OWNER/OPERATORS ONLY)

Equipment Description (Tractor):

Type:

Year:

Make:

Model:

Color:

VIN:

2

Weight

Mileage

Fifth Wheel Height

EDUCATION

List highest grade completed: Grade 12

List last school attended (name, city, and

state):

Pine Forest Fayetteille,NC

PERSONAL REFERENCES

List name, address, city, state, phone number, and relationship: First Reference: Vinny Elliott 419 Slocomb Rd Fayetteville NC 717-***-**** Friend

Second Reference: Craige Mitchell 210 Spring Lake NC 910-***-**** Friend

Licenses

License Number 578

State/Province NC

Country United States

License Class Class A

License Expiration Date 12-04-2016

Physical Expiration Date 03-04-2014

Current License Yes

Commercial Driver License Yes

Endorsements

Tanker Endorsement Yes

HAZMAT Endorsement Yes

Hazmat Expiration Date 03-04-2014

X Endorsement Yes

Doubles Triples Endorsement No

Other Endorsement No

3

Employment / Unemployment

Unemployment

Start Date 07-2012

End Date 08-2013

Comment still collecting

Covenant Transport

Company Covenant Transport

Start Date 01-2012

End Date 07-2012

Address 400 Birmingham

City, State/Province Zip/Postal Chattanooga, TN 37419 Phone 423-***-****

Fax 423-***-****

Position Held O/O company driver

Reason for leaving? had bad team driver

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) 46

Most common truck driven Conventional Tractor

Most common trailer Reefer Trailer

Trailer length 53 feet or more

Heartland Express

Company Heartland Express

Start Date 08-2010

4

End Date 12-2011

Address 2777 HEARTLAND DRIVE

City, State/Province Zip/Postal Coralville, IA 52241-9908 Phone 800-***-****

Fax 319-***-****

Position Held driver

Reason for leaving? work with O/O

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 2500-3000

Pay Range (cents/mile) 46

Most common truck driven Conventional Tractor

Most common trailer Van

Trailer length 53 feet or more

Marten Transport, Ltd

Company Marten Transport, Ltd

Start Date 05-2007

End Date 08-2010

Address 129 Marten Street

City, State/Province Zip/Postal Mondovi, WI 54755

Phone 800-***-****

Fax 800-***-****

Position Held driver

Reason for leaving? regional job

Were you terminated/discharged/laid off? No

5

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) 42

Most common truck driven Conventional Tractor

Most common trailer Reefer Trailer

Trailer length 53 feet or more

deBoer Transportation, Inc

Company deBoer Transportation, Inc

Start Date 09-2006

End Date 05-2007

Address 8814 County Road F

City, State/Province Zip/Postal Blenker, WI 54415

Phone 715-***-****

Fax 888-***-****

Position Held driver

Reason for leaving? forced per diem

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

Yes

6

Did you perform any safety sensitive

functions in this job, regulated by DOT,

and subject to drug and alcohol testing?

Areas Driven 48 states

Miles driven weekly 2500-3000

Pay Range (cents/mile) 40

Most common truck driven Conventional Tractor

Most common trailer Van

Trailer length 53 feet or more

KLLM Transport Services, LLC

Company KLLM Transport Services, LLC

Start Date 03-2006

End Date 08-2006

Address 135 Riverview Dr.

City, State/Province Zip/Postal Jackson, MS 39218

Phone 601-***-****

Fax 601-***-****

Position Held driver

Reason for leaving? terminated

Were you terminated/discharged/laid off? Yes

Termination Explanation later determined wrongful termination 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 at first

Miles driven weekly 3000-3500

Pay Range (cents/mile)

Most common truck driven Conventional Tractor

Most common trailer Reefer Trailer

7

Trailer length 53 feet or more

atlas vanlines

Company atlas vanlines

Start Date 10-2004

End Date 03-2006

Address 3715 ramsey st

City, State/Province Zip/Postal Fayetteille, NC 28301 Phone 910-***-****

Position Held driver

Reason for leaving? to run multi states

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 3-4 states

Miles driven weekly 1000-1500

Pay Range (cents/mile) hourly

Most common truck driven Conventional Tractor

Most common trailer Van

Trailer length 45 to 52 feet

Central Refrigerated Services

Company Central Refrigerated Services

Start Date 04-2004

End Date 10-2004

Address 5175 West 2100 South

City, State/Province Zip/Postal W Valley City, UT 84120 Phone 800-***-****

Position Held driver

8

Reason for leaving? reginal job(family related)

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 2500-3000

Pay Range (cents/mile) 36

Most common truck driven Conventional Tractor

Most common trailer Reefer Trailer

Trailer length 53 feet or more

Military

Branch of Service Army

Start Date 02-1985

End Date 01-1987

Can you obtain your DD214? Yes

Rank at discharge E-3

Did you receive an honorable discharge? Yes

Trucking School

Start Date 04-1985

End Date 06-1985

School US Army

City, State/Province Ft Leonardwood, MO

Country United States

Phone

9

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 200

Border Crossing Yes

Log Books Yes

Federal Motor Carrier Regulations Yes

Hazardous Materials Yes

Trucking School

Start Date 03-2004

End Date 04-2004

School CTA

City, State/Province Princeton, NC

Country United States

Phone

Did you graduate? Yes

Were you subject to the Federal Motor

Carrier or Transport Canada Safety

Regulations while attending this truck

school?

Yes

Did you perform any safety sensitive

functions at this truck school, regulated by

DOT, and subject to drug and alcohol

testing?

Yes

GPA

Hours of Instruction 160

Border Crossing Yes

Log Books Yes

Federal Motor Carrier Regulations Yes

Hazardous Materials Yes

10

Motor Vehicle Record

1. Has any license, permit or privilege ever

been denied, suspended or revoked for

any reason?

Yes

Date 07-2012

Comment 30 day civil(reversed)

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 a an illegal

substance (including but not limited to,

marijuana, amphetamines, or derivatives

thereof), 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

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 5 years? No Violations

11

Criminal Record

Have you ever been convicted of a crime? No

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?

No

If you have any felony convictions, do you

currently hold a ministers 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 FCRA

Statement of Rights.

Yes

Pre-Employment Screening Program Important Notice

I acknowledge that I have read and

understand the above Important Notice of

Rights and also have been given the

opportunity to copy/print the notice.

Yes

User Requested Copy

User requested a copy to be sent to this

email address ad3d0t@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

12

Signature

Full Name Johnny M Shelly, Sr.

Social Security Number 0880

Date of Birth

IP Address 75.178.18.55

Signature Date/Time 08-23-2013 12:29 PM

This certifies that this application was completed by me, and that all entries on it and information on it are true and complete to the best of my knowledge.

Signed Date: 08-23-2013 12:29 PM

Signed:

13

DISCLOSURE AND RELEASE

In connection with your employment or application for employment (including contract for services) through EW Wylie, 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:

johnny m shelly, Sr.

Social Security #:

0880

Signed Date: 08-23-2013

johnny m shelly, Sr.

326 Longhill Dr

Fayetteille, NC 28311

910-***-****

Gender:

14

IMPORTANT NOTICE REGARDING BACKGROUND REPORTS FROM THE PSP ONLINE SERVICE

1. In connection with your application for employment with EW Wylie ("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. The Prospective Employer cannot obtain background reports from FMCSA unless you consent in writing. If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below: 2. I authorize EW Wylie ("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 consenting to 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.

3. 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 am challenging 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. 4. Please note: 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 FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report. I have read the above Notice Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this consent form, 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:

johnny m shelly, Sr.

Social Security #:

0880

Signed Date: 08-23-2013

johnny m shelly, Sr.

326 Longhill Dr

Fayetteille, NC 28311

910-***-****

Gender:

15

Request/Consent for Information from Previous Employer(s)/Carrier(s) For Alcohol and Controlled Substances Testing Records

And changes in Parts 390 and 391 of the FMCSA

X 08-23-2013

Date

X 0880

Social Security Number

johnny m shelly, Sr.

326 Longhill Dr

Fayetteille, NC 28311

910-***-****

Gender:

X johnny m shelly, Sr.

Print Name (First, MI, Last)

X

Signature

I, the above mentioned signer, hereby authorize Heartland Express To release and forward in accordance with the following regulation, all known information pertaining to my alcohol and controlled substances testing/training records to EW Wylie

DISCLOSURE AND RELEASE

In accordance with DOT Regulation 49 CFR Part 391.23, I authorize the release of information from my DOT regulated drug and alcohol testing records by the carriers (company/school) listed above to EW Wylie, or to HireRight for the sole purpose of transmitting such records to EW Wylie. I authorize release of the following information concerning DOT drug and alcohol testing violations including pre-employment tests during the past three years: (i) alcohol tests with a result of 0.04 or higher; (ii) verified positive drug tests; (iii) refusals to be tested (including verified adulterated or substituted results); (iv) other violations of DOT drug and alcohol testing regulations; (v) information obtained from previous employers of a drug and alcohol rule violation(s); and (vi) documents, if any, of completion of a return-to-duty process following a rule violation. I also authorize the carriers (company/school) listed above to release information about names and dates of previous employers, reasons for termination of employment, work experience, accidents, academic history, professional credentials and other information. The information that I have authorized EW Wylie or HireRight to review involves tests required by DOT. If any carrier

(company/school) listed above furnishes EW Wylie or HireRight with information concerning items (i) through (vi) above, I also authorize that carrier (company/school) to release and furnish the dates of my negative drug and/or alcohol tests and/or tests with results below 0.04 during the three-year period and the name and phone number of any substance abuse professional who evaluated me during the past three years.

16

Request/Consent for Information from Previous Employer(s)/Carrier(s) For Alcohol and Controlled Substances Testing Records

And changes in Parts 390 and 391 of the FMCSA

X 08-23-2013

Date

X 0880

Social Security Number

johnny m shelly, Sr.

326 Longhill Dr

Fayetteille, NC 28311

910-***-****

Gender:

X johnny m shelly, Sr.

Print Name (First, MI, Last)

X

Signature

I, the above mentioned signer, hereby authorize Covenant Transport To release and forward in accordance with the following regulation, all known information pertaining to my alcohol and controlled substances testing/training records to EW Wylie

DISCLOSURE AND RELEASE

In accordance with DOT Regulation 49 CFR Part 391.23, I authorize the release of information from my DOT regulated drug and alcohol testing records by the carriers (company/school) listed above to EW Wylie, or to HireRight for the sole purpose of transmitting such records to EW Wylie. I authorize release of the following information concerning DOT drug and alcohol testing violations including pre-employment tests during the past three years: (i) alcohol tests with a result of 0.04 or higher; (ii) verified positive drug tests; (iii) refusals to be tested (including verified adulterated or substituted results); (iv) other violations of DOT drug and alcohol testing regulations; (v) information obtained from previous employers of a drug and alcohol rule violation(s); and (vi) documents, if any, of completion of a return-to-duty process following a rule violation. I also authorize the carriers (company/school) listed above to release information about names and dates of previous employers, reasons for termination of employment, work experience, accidents, academic history, professional credentials and other information. The information that I have authorized EW Wylie or HireRight to review involves tests required by DOT. If any carrier

(company/school) listed above furnishes EW Wylie or HireRight with information concerning items (i) through (vi) above, I also authorize that carrier (company/school) to release and furnish the dates of my negative drug and/or alcohol tests and/or tests with results below 0.04 during the three-year period and the name and phone number of any substance abuse professional who evaluated me during the past three years.

17

DISCLOSURE AND RELEASE

In connection with your employment or application for employment (including contract for services) through EW Wylie, 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.

Employer / Contractor / Educational Institution:

atlas vanlines

Printed Name:

johnny m shelly, Sr.

Social Security



Contact this candidate