Ryder Integrated Logistics, Inc.
DOT#******
Miami, FL 33178
**-**-**** *:42:21AM CDT
IntelliApp
Personal Information
Name Abed-nego Lubin, Sr.
Current Address ***** ** **nd Street
Address 2 18551 Nw 22nd Street
City, State/Province Zip/Postal Pembroke Pines, FL 33029 Country United States
Residence 3 years or longer (If No,
previous addresses shown below)
Yes
SSN/SIN 2205
Date of Birth
Primary Phone 786-***-****
Cell Phone 786-***-****
Preferred method of contact Primary Phone
Best time to contact you Any
Email ****************@*****.***
Yes, I agree to receive information
concerning future opportunities or
promotions from Ryder Integrated
Logistics, Inc. DOT#165420 by email or
other commercial electronic
communications.
Yes
Would you like to receive communication
from Ryder Integrated Logistics, Inc.
DOT#165420 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 Ryder
Integrated Logistics, Inc. DOT#165420's
service provider receives in real time and
logs your text messages with Ryder
Integrated Logistics, Inc. DOT#165420.
Yes
1
Company Questions
GENERAL INFORMATION
Are you currently authorized to work in the
United States on a full-time basis for any
employer?
No
If you answered YES to the question
above, will you require now or in the near
future employment visa sponsorship (i.e.,
H-1B visa)?
Are you currently employed? Yes
What date did your last employment end?
Do you read, write, and speak English? Yes
Are you currently employed with Ryder
Integrated?
No
Have you ever worked for this company
before?
No
Enter start and end dates, location,
position, and reason for leaving:
Do you have a current TWIC card? No
Expiration date:
Have you ever been known by any other
name?
No
Enter name:
Please enter the names of any relatives
employed here:
Abed lubin
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 None
Tractor and Semi-Trailer None
Tractor - Two Trailers Tractor trailer
Other None
Which safe driving awards do you hold and
from whom?
None
EQUIPMENT (OWNER/OPERATORS ONLY)
Equipment Description (Tractor):
Type: Tractor trailer
Year: None
2
Make: Freightliner
Model: None
Color: Silver
VIN: None
Weight None
Mileage 52,000
Fifth Wheel Height
EDUCATION
List highest grade completed: Grade 9
List last school attended (name, city, and
state):
Metropolitan CDL training and testing.
PERSONAL REFERENCES
List name, address, city, state, phone number, and relationship: First Reference: None
Second Reference: None
Have you completed your registration for
the FMCSA Drug & Alcohol
Clearinghouse?
Yes
Applicant Workflow ID 2336806
Person ID 1620990
System ID 2336806
Licenses
License Number 680
State/Province FL
Country US
License Class Class A
License Expiration Date 10-08-2029
Physical Expiration Date 09-08-2023
Current License Yes
Commercial Driver License Yes
Endorsements None
3
Employment / Unemployment
MSA LLC group
PLEASE DO NOT CONTACT
Company MSA LLC group
Contact / Supervisor Name
Start Date 06-2022
End Date 07-2022
Address 2646 Highway ave
Address 2 2646 highway ave
City, State/Province Zip/Postal Highland, IL 46322 Country United States
Phone 708-***-****
Position Held Driver
Reason for leaving? Better opportunity
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? No
Did you operate a commercial motor
vehicle?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Did you perform any safety sensitive
functions in this job subject to drug and
alcohol testing?
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Trailer length
MSA LLC
Company MSA LLC
Contact / Supervisor Name
Start Date 05-2022
4
End Date 07-2022
Address 4801 Franklin Ave RM 205D
Address 2 Des Moines,IA
City, State/Province Zip/Postal Des Moines Ia, IL 50310 Country United States
Phone 305-***-****
Position Held Driver
Reason for leaving? Better opportunity
Were you terminated/discharged/laid off? No
Is this your current employer? Yes
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
No
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Yes
Areas Driven Overtheraod
Miles driven weekly 3500+
Pay Range (cents/mile)
Most common truck driven Tractor Trailer
Most common trailer Van
Trailer length 53 feet or more
Walker Delivery Services Inc
PLEASE DO NOT CONTACT
Company Walker Delivery Services Inc
Contact / Supervisor Name
Start Date 06-2022
End Date 06-2022
Address PO Box 1133
City, State/Province Zip/Postal Goshen, IN 46527
Country United States
Phone 561-***-****
5
Position Held Casier
Reason for leaving? Better jobs
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? No
Did you operate a commercial motor
vehicle?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Trailer length
No company name
Company No company name
Contact / Supervisor Name
Start Date 04-2022
End Date 05-2022
Address 4903 Oakbrook Dr
City, State/Province Zip/Postal Louisville, KY 40245 Country United States
Phone 786-***-****
Position Held Technicien
Reason for leaving? Better jobs
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 No
6
vehicle?
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
Vamar trucking
PLEASE DO NOT CONTACT
Company Vamar trucking
Contact / Supervisor Name
Start Date 04-2022
End Date 05-2022
Address XERODOC LLC
Address 2 4155 nw 100th ave
City, State/Province Zip/Postal Coral Springs Fl,, FL 33065 Country United States
Phone 786-***-****
Position Held Desk front
Reason for leaving? Better jobs
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? No
Did you operate a commercial motor
vehicle?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
7
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
Vamar trucking
Company Vamar trucking
Contact / Supervisor Name
Start Date 03-2022
End Date 05-2022
Address XERODOC LLC
Address 2 4155 nw 100th ave
City, State/Province Zip/Postal Coral Springs Fl,, FL 33065 Country United States
Phone 786-***-****
Position Held Desk front
Reason for leaving? Better jobs
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)
8
Most common truck driven
Most common trailer
Trailer length
DK Max Trucking
Company DK Max Trucking
Contact / Supervisor Name
Start Date 01-2022
End Date 03-2022
Address 1005 Sharon Park
Address 2 LN Cincinnati, Ho,USA
City, State/Province Zip/Postal Cincinnati, OH 45241 Country United States
Phone 305-***-****
Position Held Company Driver
Reason for leaving? Still Employed
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 3500+
Pay Range (cents/mile)
Most common truck driven Conventional Tractor
Most common trailer Van
Trailer length 53 feet or more
Lykins Transportation
PLEASE DO NOT CONTACT
Company Lykins Transportation
9
Contact / Supervisor Name
Start Date 02-2022
End Date 03-2022
Address 5163 Wolfpen-Pleasant Hill Rd.
City, State/Province Zip/Postal Milford, OH 45150
Country United States
Phone 561-***-****
Fax 513-***-****
Position Held Driver
Reason for leaving? Better opportunity
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? No
Did you operate a commercial motor
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
No
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
No
Areas Driven OTR
Miles driven weekly 3500+
Pay Range (cents/mile)
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
SPI Security
Company SPI Security
Contact / Supervisor Name
Start Date 10-2018
End Date 12-2021
Address 1771 N Flamingo Rd,
City, State/Province Zip/Postal Pembroke Pines, FL 33028 Country United States
10
Phone 561-***-****
Position Held supervisor
Reason for leaving? Resigned
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
Walmart (DOT)
PLEASE DO NOT CONTACT
Company Walmart (DOT)
Contact / Supervisor Name
Start Date 07-2021
End Date 11-2021
Address 12800 pines blvd
City, State/Province Zip/Postal Pembroke Pines, FL 33027 Country United States
Phone 561-***-****
Fax 877-***-****
Position Held Casier
Reason for leaving? Better job
Were you terminated/discharged/laid off? No
Is this your current employer? No
11
May we contact this employer at this time? No
Did you operate a commercial motor
vehicle?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Trailer length
Delta bureau
Company Delta bureau
Contact / Supervisor Name
Start Date 09-2019
End Date 10-2021
Address 1771 N flamingo Rd, Pembroke P
Address 2 1771 N Flamingo Rd, Pembroke P
City, State/Province Zip/Postal Pembroke Pines, FL 33028 Country United States
Phone 561-***-****
Position Held Security officer
Reason for leaving? Looking Job for a truck 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?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
12
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
FPI Security
Company FPI Security
Contact / Supervisor Name
Start Date 10-2019
End Date 10-2021
Address 1771 N flamingo Rd,pembroke p
Address 2 1771 N Flamingo Rd,pembroke pi
City, State/Province Zip/Postal Pembroke Pines, FL 33028 Country United States
Phone 561-***-****
Position Held Supervisor
Reason for leaving? Personal
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)
13
Most common truck driven
Most common trailer
Trailer length
Unemployment
Start Date 12-2016
End Date 09-2018
Comment Out of the country and was visiting family in Haiti.
Conventon security
Company Conventon security
Contact / Supervisor Name
Start Date 07-2012
End Date 11-2016
Address Delmas 18
Address 2 Delmas 18#3
City, State/Province Zip/Postal Port-au-prince, HAITI 34567 Country Haiti
Phone 097-***-****
Position Held Security officer
Reason for leaving? Better opportunity
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
No
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven
14
Most common trailer
Trailer length
Education
School Name Bwoward colleges
Start Date 01-2022
End Date 05-2022
City, State/Province Pembroke Pines, FL
Country US
What did you study? Anglais
Phone 786-***-****
Graduation Date 04-2022
Education
School Name FPI security school
Start Date 01-2022
End Date 04-2022
City, State/Province Pembroke Pines, FL
Country US
What did you study? Security study
Phone 786-***-****
Graduation Date 04-2022
Education
School Name Sheridan Technical Colleges
Start Date 09-2021
End Date 12-2021
City, State/Province Hollywood, FL
Country US
What did you study? English
Phone 786-***-****
Graduation Date 04-2021
15
FMCSR
Under FMCSR 391.15, are you currently
disqualified from driving a commercial
motor vehicle? [49 CFR 391.15]
No
Has your license, permit or privilege to
drive ever been suspended or revoked for
any reason? [49 CFR 391.21(b)(9)]
No
Have you ever been denied a license,
permit, or privilege to operate a motor
vehicle?[49 CFR 391.21(b)(9)]
No
Within the past two years, have you tested
positive, or refused to test, on a
pre-employment drug or alcohol test by an
employer to whom you applied, but did not
obtain, safety-sensitive transportation work
covered by DOT agency drug and alcohol
testing rules? [49 CFR 40.25(j)]
No
In the past three(3) years, have you ever
been convicted of any of the following
offenses: [49 CFR 391.15]:
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
16
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 04-2020
Hazmat Accident / Incident No
Was the vehicle towed away? No
City Miami
State/Province FL
Were you in a commercial vehicle? No
If yes, was this a Department of
Transportation recordable accident?
Were you at fault? No
Were you ticketed? No
Description Somebody Hit the back off my car, I was not at fault.
Traffic Convictions \ Violations
Have you had any moving violations or traffic convictions in the past 3 years? No Violations
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
17
Signature
Full Name Abed-nego Lubin, Sr.
IP Address 2600:387:15:1516
Signature Date/Time 07-21-2022 9:42 AM
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: 07-21-2022 9:42 AM
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
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
Yes
18
electronic signature to demonstrate my
consent. An electronic signature is as
legally binding as an ink signature.
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
Summary of Rights Under 15 U.S.C. Section 1681m(a) By checking the box, I (a) acknowledge
that I have read and understand the
Summary of Rights Under 15 U.S.C.
Section 1681m(a) and have been given
the opportunity to copy/print the 1681m
Summary of Rights and (b) agree to use
an electronic signature to demonstrate my
consent. An electronic signature is as
legally binding as an ink signature.
Yes
INVESTIGATIVE CONSUMER REPORT DISCLOSURE
By checking this box, I represent that I
understand and agree to the above
Investigative Consumer Report
Disclosure.
Yes
User Requested Copy
User requested a copy to be sent to this
email address
****************@*****.***.
Yes
19
DISCLOSURE AND AUTHORIZATION TO REQUEST CONSUMER REPORTS & INVESTIGATIVE DISCLOSURE
Ryder System Inc. ('COMPANY') will obtain a consumer report and/or investigative consumer report ("Report") that contains background information about you from First Advantage Enterprise Screening Corporation ("First Advantage"), 1 Concourse Parkway NE Suite 200 Atlanta, GA 30328 (http://www.FADV.com), 1-866-***-****, as part of the hiring process for this position and for any future position for which you are considered. If you are hired, to the extent permitted by law, COMPANY may obtain further Reports from First Advantage throughout your employment for an employment purpose without providing further disclosure or obtaining additional consent. The Reports may include, but are not limited to, information regarding your character, general reputation, personal characteristics and standard of living, educational and employment history, drug/alcohol test results, OFAC/terrorist watch list, sex offender search, Social Security verification and address history, driving record and criminal record and accident history as required by the Federal Motor Carrier Safety Act, subject to any limitations imposed by applicable federal and state law. This information may be obtained through direct or indirect contact with public and private sources, including former employers, schools and public agencies or other sources. If an investigative consumer report is requested, in addition to the description above, the nature and scope of any such report will be employment verifications and references, or personal references.
The specific type of report most often requested is criminal record, driving record, accident history, and employment history. You have the right to request a complete disclosure of the nature and scope of the consumer report requested and/or prepared.
AUTHORIZATION
I have carefully read the foregoing Disclosure and this Authorization. By signing below, I consent to and authorize the COMPANY to obtain from First Advantage the Reports described above relating to me for employment purposes. I acknowledge receipt of a copy of the "A Summary of Your Rights Under the Fair Credit Reporting Act." Printed Name:
Abed-nego Lubin, Sr.
Social Security #:
2205
Signed Date: 07-21-2022
Abed-nego Lubin, Sr.
18551 Nw 22nd Street
18551 Nw 22nd Street
Pembroke Pines, FL 33029
Gender:
20
DISCLOSURE & AUTHORIZATION FOR BACKGROUND INVESTIGATION The Company will utilize the services of a third-party agency or consumer reporting agency to obtain a consumer report for purposes of evaluating your application, appointment and/or contract terms at the time of application and throughout your affiliation with the Company. The term "consumer report" includes communications by a third-party agency or consumer reporting agency bearing on your criminal background, driving record, education, prior employment, credit history, character or mode of living. Credit history will only be requested where such information is substantially related to the duties and responsibilities of the position for which you are applying or are employed in. Pursuant to the Fair Credit Reporting Act, the Company is required to obtain your permission prior to procuring the consumer report. By signing below, you hereby authorize the Company to procure report(s) on your background as described above from any third-party or consumer reporting agency contacted by the Company. You further authorize ongoing procurement of the above-mentioned report(s) at any time that you are considered for another position with the Company or at any time during your association with the Company. Printed Name:
Abed-nego Lubin, Sr.
Social Security #:
2205
Signed Date: 07-21-2022
Abed-nego Lubin, Sr.
18551 Nw 22nd Street
18551 Nw 22nd Street
Pembroke Pines, FL 33029
Gender:
21
IMPORTANT DISCLOSURE
REGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with Ryder Integrated Logistics, Inc. DOT#165420 ("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 Ryder Integrated Logistics, Inc. DOT#165420 ("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