Non-Cdl Yrs Experience

Applicant Name: Phil Andrew Allen

Company Name: Amazon Logistics, Inc.

Company Address: 410 Terry Ave N Seattle, WA 98109-5210 Submitted Date/Time: September 19, 2022 04:09 PM (CDT) 1.PERSONAL INFORMATION

Applicant Details

Last Name: Allen

First Name: Phil

Middle Name: Andrew

Birth Date: September 28, 1983

Identification Country USA

SSN/SIN/Other Identification Number: ***-**-****

Phone Number: 901-***-****

Email Address: ************@*****.***

Current Residency Details

Current Address: 1616 DOLAN DR

Country: USA

State: Tennessee

County: Shelby

City: Memphis

Zip/Postal Code: 38116

Residence From: May 2012 to Sep 2022

2. EMPLOYMENT HISTORY

This position is non-CDL; you will be required to provide 3 years of employment history below. Current or Most Recent Employer /Company Name /Truck Driving School /Self Employment Are you currently employed? No

Account for period if not employed:

From: Aug 2022 to Sep 2022

Employment Status: Laid-Off

Employer 1

Employer/Company Name: Collierville Chrysler Dodge Jeep Ram Phone Number: 901-***-****

Address: 393 S. Byhalia Road

Country: USA

State: Tennessee

City: COLLIERVILLE

Zip/Postal Code: 38017

Position Held: Salesman

From: Nov 2017 to Nov 2021

Reason for Leaving: Took Different Job

Were you subject to the FMCSRs while employed? No

Was your job designated as a safety-sensitive

function in any DOT-regulated mode subject to the

drug and alcohol testing requirements of 49 CFR

Part 40?

No

Account For Period Between UnEmployment & Employer & 1 From: Dec 2021 to Jul 2022

Employment Status: Not Working

Employer 2

Employer/Company Name: Memphis grizzlies

Phone Number: 901-***-****

Address: 191 Beale St

Country: USA

State: Tennessee

City: MEMPHIS

Zip/Postal Code: 38106

Position Held: Account manager of security

From: Aug 2008 to Nov 2017

Reason for Leaving: Resigned

Were you subject to the FMCSRs while employed? No

Was your job designated as a safety-sensitive

function in any DOT-regulated mode subject to the

drug and alcohol testing requirements of 49 CFR

Part 40?

No

3. EXPERIENCE AND QUALIFICATIONS

Driving Experience

Commercial Driving experience in the last 3 years: No Accident Details

In the last 3 years, have you been in an Accident? No Traffic Conviction and/or Forfeitures Details

In the last 3 years, have you had any traffic

convictions and/or forfeitures?:

No

Current License Information

Current State of Residence: Tennessee

No license in this state yet: No

Current License Number: 108470224

License Class: Other

Expiration Date: 11/06/2026

Other Information

Have you ever been denied a license, permit, or

privilege to operate a motor vehicle? No More

Information:

No

More Information:

Has any license, permit or privilege ever been

suspended or revoked?

No

More Information:

4. UPLOAD RELATED DOCUMENTS

Below are the documents that have been uploaded

Document Type Document Title

Driver’s License (Front) 16636210440257205005475100339208.Pdf Driver’s License (Back) 16636211416578342773871865971704.Pdf Document Type Document Title

Medical Certificate 16636214466133766555970195349329.Pdf 5. FORMS

Below are the disclosure documents that have been uploaded Document Section Document Name

Disclosures & Authorizations Summary of Rights Under the Fair Credit Reporting Act

Disclosures & Authorizations Disclosure Regarding Investigative Background Investigation

Disclosures & Authorizations Acknowledgement and Authorization for Background Check

Disclosures & Authorizations Disclosure Regarding Background Investigation 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 current 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.

Applicant Certification

By clicking this box, I certify 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. This application is being completed for: Amazon Logistics, Inc. 410 Terry Ave N Seattle, WA 98109-5210 ACKNOWLEDGEMENT FOR ELECTRONIC SIGNATURE

Your Name: Phil Andrew Allen

Your SSN's Last Four Numbers: 3731

* I acknowledge that my name and my (SSN/Last four SSN) which is displayed above, is accurate, and by checking the Acceptance Box, and by clicking on the “Next Document” Button below, I am electronically signing the above document.

* I understand that my electronic signature will be binding as though I had physically signed this document by hand. I agree that a printout of this authorization may be accepted with the same authority as the original. Signature:

Date: 9/19/2022

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