Shuttle. York. PA.
Resume:
S&H Express Inc.
Granite Transportation
*** *. ***** ****** *.O. Box 20219
York, PA 17403
**-**-**** *:30:31PM CDT
IntelliApp
Thank you for your interest in S&H Express or Granite Transportation. 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: https://joinsandhexpress.com
Name Mark W John
Residence 3 years or longer (If No,
previous addresses shown below)
Yes
Current Address 2160 Suburban Road. Appt. D
City, State/Province Zip/Postal York, PA 17403
Country United States
Residence 3 years or longer (If No,
previous addresses shown below)
Yes
SSN/SIN 4005
Date of Birth
Primary Phone 717-***-****
Preferred method of contact Primary Phone
Best time to contact you Any
Email adqrpm@r.postjobfree.com
Please select the recruiter you have been
in contact with.
Yes, I agree to receive information
concerning future opportunities or
promotions from S&H Express Inc. by
email or other commercial electronic
communications.
Yes
Would you like to receive communication
from S&H Express Inc. via text message?
By participating, you consent to receive
Yes
1
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 S&H
Express Inc.'s service provider receives in
real time and logs your text messages with
S&H Express Inc..
Company Questions
GENERAL INFORMATION
Position desired? Yard Jockey
Location desired? Jockey
Are you legally eligible for employment in
the United States?
Yes
Are you a veteran? Yes
Are you currently employed? No
What date did your last employment end? 4-7-2022. Jockey @ Pixxel in Spring Grove. PA.
Do you read, write, and speak English? Yes
Have you ever worked for this company
before?
Yes
Enter start and end dates, location,
position, and reason for leaving:
Was NE Regional with Ya All. Went OTR
with Celedon. All 48. Now. Am grounded.
Home here. With Family and older too.
2013 with Yall. Just wanted to see Our
BEAUTIFUL COUNTRY. We all live in.
Really liked Sharon as my DM. Hit a
Turkey with one of your 2006 Int. Tractor
s.
Do you have a current TWIC card? No
Expiration date:
When you completed your final CDL Test
to obtain your license, was your test
completed in a manual transmission truck
or an automatic transmission truck?
Manual transmission
Please enter the names of any relatives
employed here:
None I know of.
Have you ever been known by any other
name?
No
Enter name:
2
How did you hear about us? Driving School
If "Referred by a Friend", what is their
name?
Myself.
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 1988-1999. 70,000. Maybe more.
Tractor and Semi-Trailer 6-2012. To Present. Day. Miles. And 6 Years was OTR. Was Dedicated for NFI.
Y'all NE Reg. Kinard Local. And start of
Jocking. About 500,000 miles. Probably
more.
Tractor - Two Trailers O
Other Flatbed. For Maverick. Glass. Hauler.
Double and Single drop beds. Went to
Canada and 48 states. In 2012. First OTR.
Job.
Which safe driving awards do you hold
and from whom?
Used to.lost. through moving around.
Standard Roofing in 1991. Class B.
EQUIPMENT (OWNER/OPERATORS ONLY)
Equipment Description (Tractor):
Type:
Year:
Make:
Model:
Color:
VIN:
Weight
Mileage
Fifth Wheel Height
EDUCATION
List highest grade completed:
List last school attended (name, city, and
state):
YORK TECH. TRACTOR TRAILER
SCHOOL. YORK. PA.
PERSONAL REFERENCES
List name, address, city, state, phone number, and relationship: First Reference: Cindy Ipock. Friend. For 30 years. Red Lion. PA. 717-***-****.
3
Second Reference: Jerry & Holly Purcell Friends. Known for 50 years. But Jerry. 8 years. Jefferson. TX.
Licenses
License Number 062
State/Province PA
Country United States
License Class Class A
License Expiration Date 10-12-2022
Physical Expiration Date 12-23-2021
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
R. J. Davis
Company R. J. Davis
Start Date 06-2021
End Date 04-2022
Address
City, State/Province Zip/Postal Dover, PA 17368
Country United States
Phone 717-***-****
Fax 717-***-****
Position Held
Reason for leaving? Conflict with days off and. Hrly pay. Changing hours.
Were you terminated/discharged/laid off? No
Is this your current employer? Yes
4
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 SPRING GROVE. PA. JOCKING
Miles driven weekly 0-500
Pay Range (cents/mile) 24. An hr.
Most common truck driven Yard Horse
Most common trailer Van
Trailer length 53 feet or more
Unemployment
Start Date 01-2021
End Date 05-2021
Comment Medical Leave.
A &S Kinard
Company A &S Kinard
Start Date 07-2018
End Date 01-2021
Address
City, State/Province Zip/Postal York, PA 17404
Country United States
Phone 717-***-****
Position Held Pixxel. Jockey 2nd shift
Reason for leaving? Medical Leave. Needed Surgery
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
5
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 Local. Jocking
Miles driven weekly 1000-1500
Pay Range (cents/mile) 23 ? An hour
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Freymiller Inc.
Company Freymiller Inc.
Start Date 02-2017
End Date 06-2018
Address 8125 SW 15th Street
City, State/Province Zip/Postal Oklahoma City, OK 73128 Country United States
Phone 405-***-****
Position Held OTR. 48 States
Reason for leaving? Quit. Family medical. Situation 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. Cali to Maine. To Fl. Texas. Wyoming. Colorad.
Miles driven weekly 2500-3000
6
Pay Range (cents/mile) 45 cents a mile
Most common truck driven Tractor-Trailer
Most common trailer Reefer Trailer
Trailer length 53 feet or more
Celedon Trucking
Company Celedon Trucking
Start Date 02-2016
End Date 03-2017
Address Indianapolis
City, State/Province Zip/Postal Indianapolis, IN
Country United States
Phone
Position Held OTR
Reason for leaving? Quit. Low pay
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 All 48
Miles driven weekly 2000-2500
Pay Range (cents/mile) 45 cents a mile
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
NFI / NFI Interactive Logistics LLC
Company NFI / NFI Interactive Logistics LLC
Start Date 02-2015
End Date 01-2016
7
Address 2 Cooper Street
City, State/Province Zip/Postal Camden, NJ 08102
Country United States
Phone 856-***-****
Fax 856-***-****
Position Held Dedicated.
Reason for leaving? Quit. Ins. No good. DM. Was. Bad 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 NE
Miles driven weekly 2000-2500
Pay Range (cents/mile) Guaranteed 1000 per
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
S & H Express
Company S & H Express
Start Date 01-2014
End Date 01-2015
Address 728 N Broad St
City, State/Province Zip/Postal York, PA 17403
Country United States
Phone
Position Held
Reason for leaving? Quit. Low pay
Were you terminated/discharged/laid off? No
8
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 NE
Miles driven weekly 2000-2500
Pay Range (cents/mile) 35 cents a mile
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Pascal Trucking LLLC.
Company Pascal Trucking LLLC.
Start Date 07-2013
End Date 12-2013
Address
City, State/Province Zip/Postal Murrey, KY
Country United States
Phone
Position Held
Reason for leaving? Quit. Low pay
Were you terminated/discharged/laid off? Yes
Termination Explanation Left go. Due to would not haul Hazmat without a hazmat lic. They were in the
wrong.
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 All 48
Miles driven weekly 1500-2000
Pay Range (cents/mile) 35 cents a mile
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Maverick Transportation Llc
Company Maverick Transportation Llc
Start Date 07-2012
End Date 06-2013
Address
City, State/Province Zip/Postal North Little Rock, AR Country United States
Phone 800-***-****
Fax 501-***-****
Position Held OTR
Reason for leaving? Quit. Low pay
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 All 48. And Canada
Miles driven weekly 1500-2000
Pay Range (cents/mile) 45 cents a mile
10
Most common truck driven Tractor-Trailer
Most common trailer Flatbed
Trailer length 45 to 52 feet
Priority Post.
Company Priority Post.
Start Date 05-2011
End Date 02-2012
Address
City, State/Province Zip/Postal Emigsville, PA
Country United States
Phone
Position Held Shipper
Reason for leaving? Company shut down. Moved to N. J. 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
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Trailer length
11
U.S. Military
Branch of Service Air Force
Start Date 06-1979
End Date 01-1982
Can you obtain your DD214? Yes
Rank at discharge E-3
Trucking School
Start Date 04-2012
End Date 06-2012
School YORK COUNTY TECH
Address
Address 2
City, State/Province York, PA
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 4.0
Hours of Instruction 200
Border Crossing Yes
Log Books Yes
Federal Motor Carrier Regulations Yes
Hazardous Materials Yes
12
Trucking School
Start Date 03-2012
End Date 06-2012
School York Co. School of Technology
Address
Address 2
City, State/Province York, PA
Country United States
Phone 717-***-****
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 good
Hours of Instruction 100
Border Crossing No
Log Books Yes
Federal Motor Carrier Regulations Yes
Hazardous Materials Yes
Education
School Name York Vocational Technolgy. Over at S. & Start Date 03-2012
End Date 06-2012
City, State/Province York, PA
Country US
What did you study? Truck Driving School
Phone 700000000
Graduation Date 06-2012
13
Motor Vehicle Record
1. Has any license, permit or privilege ever
been denied, suspended or revoked for
any reason?
No
2. Have you ever been convicted of driving
during license suspension or revocation, or
driving without a valid license or an expired
license, or are any charges pending?
No
3. Have you ever been convicted for any
alcohol or controlled substance related
offense while operating a motor vehicle, or
are any charges pending?
No
4. Have you ever been convicted for
possession, sale or transfer of an illegal
substance (including but not limited to,
marijuana, amphetamines, or derivatives
thereof) while on duty, or are any charges
pending?
No
5. Have you ever been convicted of
reckless driving, careless driving or
careless operation of a motor vehicle, or
are any charges pending?
No
6. Have you ever tested positive, or
refused to test on a pre-employment drug
or alcohol test by an employer to whom
you applied, but did not obtain
safety-sensitive transportation work
covered by DOT agency drug and alcohol
testing rules in past three years, or have
you ever tested positive or refused to test
on any DOT-mandated drug or alcohol
test?
No
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 3 years? No Violations
14
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 minister's permit to enter
or exit Canada?
No
Have you, within the last five years, pled
"guilty" to, been convicted of, had
prosecution deferred in connection with, or
pled "no contest" to a misdemeanor?
No
Signature
Full Name Mark W John
IP Address 2607:fb90:2b2a:9
Signature Date/Time 04-08-2022 2:30 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. Signed Date: 04-08-2022 2:30 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
15
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
Additional Consent or Certification
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 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
16
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 this box, I represent that I
understand and agree to the above
language.
Yes
INVESTIGATIVE CONSUMER REPORT DISCLOSURE
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 adqrpm@r.postjobfree.com.
Yes
17
DISCLOSURE FOR CONSUMER REPORTS
In connection with your employment or owner-operator (independent contractor) application, S&H Express Inc. 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 history, 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 (including but not limited to CDLIS Central Site, CDLIS Master Pointer Record data and your driver record from the jurisdiction identified in the CDLIS data, in accordance with applicable state law and the Driver Privacy Protection Act), former employers, public court records, and federal, state, and other government agencies that maintain such records. Printed Name:
Mark W John
Social Security #:
4005
Signed Date: 04-08-2022
Mark W John
2160 Suburban Road. Appt. D
York, PA 17403
Gender:
18
AUTHORIZATION FOR CONSUMER REPORTS
I authorize S&H Express Inc. 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:
Mark W John
Social Security #:
4005
Signed Date: 04-08-2022
Mark W John
2160 Suburban Road. Appt. D
York, PA 17403
Gender:
19
IMPORTANT DISCLOSURE
REGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with S&H Express Inc. ("Prospective Employer"), Prospective Employer, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration
(FMCSA).
When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report. When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act. Neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication.
Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report. The Prospective Employer cannot obtain background reports from FMCSA without your authorization. AUTHORIZATION
If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below: I authorize S&H Express Inc. ("Prospective Employer") to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am authorizing the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee.
I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication. I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear on my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report. I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this Disclosure and Authorization, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above. Printed Name:
Mark W John
Signed Date: 04-08-2022
20
Consent for Limited Queries of the Federal Motor Carrier Safety Administration (FMCSA) Drug and Alcohol Clearinghouse
I hereby provide consent to S&H Express Inc. to conduct a limited query of the FMCSA Commercial Driver's License Drug and Alcohol Clearinghouse to determine whether drug or alcohol violation information about me exists in the Clearinghouse. I understand this consent shall remain on file and shall serve as ongoing consent for S&H Express Inc. to conduct multiple limited queries of the Clearinghouse at any time during my employment or contract period without asking me for additional consent. I understand that if I refuse to provide consent for S&H Express Inc. to conduct a limited query of the Clearinghouse, S&H Express Inc. is required to prohibit me from performing safety-sensitive functions, including operating a commercial motor vehicle. I understand that if the limited query conducted by S&H Express Inc. indicates that drug or alcohol information exists about me in the Clearinghouse, the FMCSA will not disclose that information to S&H Express Inc. unless I give additional specific consent within the Clearinghouse. However, I understand that S&H Express Inc. will be required to conduct a full query of the Clearinghouse within 24 hours after a limited query indicates that drug or alcohol information exists and that if I do not grant consent within the Clearinghouse for that full query I will be removed from performing safety-sensitive functions, including operating a commercial motor vehicle. 04-08-2022
Mark W John Date
21
PENNSYLVANIA
BUREAU OF WORKER'S COMPENSATION
EMPLOYEE RELEASE
I hereby authorize the Pennsylvania Bureau of Worker's Compensation to search and release any and all claims to HireRight with regards to the following
Contact this candidate