Driver Per Diem

COMPANY DRIVER DATA SHEET

USX legal Dept. Approved Form 03/2021

Established: 08/2012 Rev 11/2019

Company_Driver_Data_Sheet_TenStreet.4.0_d

ocx__002 002_.docx

DocType DRDTA

HIRE TYPE TRANSFER FROM ID#

FULL NAME FIRST NAME CALLED

DOT PHYSICAL EXPIRE DATE TM # GENDER

ETHNIC/RACE

PST RESULTS DED PST TEST DATE PASS FAILED OTR PST TEST DATE PASS

If your mailing address is different please record your mailing only address STREET ADDRESS LINE 1 OR PO BOX ADDRESS LINE 2

CITY STATE ZIP

Marital Status & Spouse’s information

MARITAL STATUS SPOUSE FIRST NAME LAST NAME PHONE

How do you want to receive your Pay and Settlement Sheet? If you elect direct deposit your payroll will be put on a MasterCard until the bank has approved the direct deposit CHECK DISPOSITION SETTLEMENT DISPOSITION

Recruiting Hiring Position and Credited Experience We pay miles based on Rand McNally HHG Mileage Guide 19 or the most current version 1. Select Hiring Position Title

2. Company Terminal / Dedicated Locations

3. PENDING VERIFICATION OF OTR EXPERIENCE IN THE LAST 120 MONTHS, YOU ARE CREDITED WITH A TOTAL OF MONTHS OF OTR EXPERIENCE. YOUR EXPERIENCE IS BASED ON MONTHS OF NON-USX AND/OR MONTHS OF USX EXPERIENCE YOUR BASE RATE OF PAY IS (PER DIEM AND BONUSES ARE NOT INCLUDED). YOU ARE ALSO CREDITED WITH MONTHS OF MILITARY EXPERIENCE. 4. PAY TYPE, IF PAY RATE IS NOT A MILEAGE RATE THEN LIST PAY AMOUNT $ . IF OTHER IS SELECTED AS THE PAY TYPE EXPLAIN 5. YOU WILL BE PAID FOR DAYS OF ORIENTATION @ PER DAY. 6. STUDENTS WILL EARN $ PER DAY SEATED ON A TRUCK AND AVAILABLE FOR A LOAD UNTIL UPGRADE AFTER STUDENT HOURS BEHIND THE WHEEL.

You understand and agree that this pay is contingent upon your hire with U.S. Xpress. You further understand and agree that this pay intended to cover all work required to pick up, transport, and deliver freight in compliance with D.O.T. regulations. You understand that your pay is subject to change should any of, but not limited to, the following transfers occur: a new account, lane, region, team, solo, hazmat, etc. If any of these changes should occur be sure to check with your supervisor. Per Diem Opt Out Option

I understand that I am automatically enrolled in the Per Diem Program. I understand that I can opt out of the program by contacting Payroll at 888- 398-1555 or by sending a Macro 53 from my truck once I am hired. Acknowledgment of Policies

I have received copies of, or have been provided access to electronic copies of, the following documents: Driver Handbook, Emergency Response Guidebook, Federal Regulations Guidelines, Hazmat Book, Drug and Alcohol Policy, Driver/Applicant Safety Performance History Records Request, and instructions for drivers submitting a request for correction or rebuttal statement. I understand that it is my responsibility to read and familiarize myself with the contents of those documents and to abide by their prescribed rules and polices. My signature below confirms that I have read the above referenced documents. I am aware that U.S. Xpress may apply an electronic reproduction of this signature to the documents listed above, and I agree that such an electronic signature will be binding upon me to the same extent as if handwritten. I also acknowledge that I have received a lighted vest and understand that U.S. Xpress has advised me to wear it when performing duties outside of the vehicle.

Driver Parking Notice

U.S. Xpress provides designated parking lots for our driver’s vehicles. I understand that while U.S. Xpress does provide parking for my vehicle, it is not responsible for or liable for the vehicle, any vehicle accessories or any personal property in the vehicle. Acknowledgment of Paperwork Changes

I acknowledge that I have had an opportunity to review and correct any changes or additions made to my U.S. Xpress employment documents and that the documents reviewed by me today are true and accurate to the best of my knowledge. I also agree that falsified information and/or significant omissions may result in my disqualification now or at any time during my employment with U.S. Xpress. I understand that U.S. Xpress uses an electronic filing and signature system which includes the imaging and storing of employment applications. I understand that any electronic signature will be binding upon me to the same extent as if handwritten. DRIVERS SIGNATURE DATE

SUPERVISOR

*DRDTA*

Initial

Initial

Initial

Initial

New 719256

Robert M Weatherspoon Robert

04-10-2024 221-***-**** M

1. BLACK/AFRICAN AMERICAN

Single

EDEP - ELECTRONIC DEPOSIT WEB - USX Web

DEDICATED OTR DRIVER (DLC) WHIRLPOOL BRIDGETON MO (WBM) 90

90 0 $0.00

0

Mileage $0.00

3 Markham IL - $107.00

$100

HOLBERT, LASHAEN

04-16-2023

RW

RW

RW

RW

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