Customer Assistance A Driver

Location:

Hayti, MO, 63851

Posted:

June 08, 2023

Contact this candidate

Resume:

Riverside Transportation Inc

**** *. ******* **

Rockport, IN 47635

913-***-****

**-**-**** **:55:22AM CDT

IntelliApp

Thank you for your interest in Riverside Transportation Inc. Riverside Transportation has many terminals across the Central United States. Orientation takes place in Kansas City, KS.

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: CDLLife_GeneralOTR

Name Anthony Kewann Williams

Residence 3 years or longer (If No,

previous addresses shown below)

Yes

Current Address 123 N Martin Luther King Dr

City, State/Province Zip/Postal Hayti, MO 63851

Country United States

Residence 3 years or longer (If No,

previous addresses shown below)

Yes

SSN/SIN 0421

Date of Birth

Primary Phone 573-***-****

Cell Phone 573-***-****

Preferred method of contact Email

Best time to contact you Afternoon

Email *****************@*****.***

Company Questions

GENERAL INFORMATION

What position are you applying for? Company Driver Driver Trainer's Name

Did you answer "Owner Operator" or "Fleet

Owner" above?

EQUIPMENT (OWNER/OPERATORS ONLY)

Equipment Description (Tractor):

Type:

Year:

Make:

Model:

Color:

VIN:

Unladen Weight:

Purchase Price:

Purchase Date:

Are you legally eligible for employment in

the United States?

Yes

Are you currently employed? No

What date did your last employment end? Nov 1 2022 Do you read, write, and speak English? Yes

Have you ever worked for this company

before?

Enter start and end dates, location,

position, and reason for leaving:

Do you have a current Passport? No

Expiration date:

Please enter the names of any relatives

employed here:

Have you ever been known by any other

name?

Enter name:

How did you hear about us? Company Website

If "Driver Referral", please enter the

driver's name

If "Other", please explain

In case of Emergency, notify (list name,

address, and phone):

Arcina Baine 573-***-****

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: Yes

Type of Equipment (van, reefer, tank, etc.):

Start Date: 04 15 20

End Date: 02 15 21

Approximate Number of Total Miles: Not available

Tractor and Semi-Trailer: No

Type of Equipment (van, reefer, tank, etc.):

Start Date:

End Date:

Approximate Number of Total Miles:

Tractor - Two Trailers: No

Type of Equipment (van, reefer, tank, etc.):

Start Date:

End Date:

Approximate Number of Total Miles:

Other:

Which safe driving awards do you hold and

from whom?

EDUCATION

List highest grade completed: GED

List last school attended (name, city, and

state):

Carver area High Chi. Il.

PERSONAL REFERENCES

List name, address, city, state, phone number, and relationship: First Reference: Arcina Baine 573-***-****

Roommate

Second Reference: Loretta Williams 573-***-**** in-law No

Have you registered for the

Clearinghouse?

Licenses

License Number 010

Licensing Authority MO

Country US

License Class

License Expiration Date 02-05-2027

Physical Expiration Date

Current License Yes

Commercial Driver License No

Endorsements

Tanker Endorsement No

HAZMAT Endorsement No

X Endorsement No

Doubles Triples Endorsement No

Other Endorsement No

Licenses

License Number 010

Licensing Authority MO

Country US

License Class

License Expiration Date 02-05-2027

Physical Expiration Date 02-05-2027

Current License Yes

Commercial Driver License No

Endorsements

Tanker Endorsement No

HAZMAT Endorsement No

X Endorsement No

Doubles Triples Endorsement Yes

Other Endorsement No

Employment / Unemployment

Unemployment

Start Date 05-2023

End Date 05-2023

Comment

Unemployment

Start Date 01-2023

End Date 02-2023

Comment

Unemployment

Start Date 07-2022

End Date 12-2022

Comment Seasonal farm work

Unemployment

Start Date 12-2019

End Date 06-2022

Comment Work at KFC, owner sold store

Education

School Name SMTDS

Start Date 03-2023

End Date 04-2023

City, State/Province Malden, MO

Country US

What did you study? CDL

Phone

Graduation Date 04-2023

FMCSR

Under FMCSR 391.15, are you currently

disqualified from driving a commercial

motor vehicle? [49 CFR 391.15]

Has your license, permit or privilege to No

drive ever been suspended or revoked for

any reason? [49 CFR 391.21(b)(9)]

Have you ever been denied a license,

permit, or privilege to operate a motor

vehicle?[49 CFR 391.21(b)(9)]

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)]

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

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

Signature

Full Name Anthony Kewann Williams

IP Address 108.234.141.50

Signature Date/Time 05-24-2023 11:55 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: 05-24-2023 11:55 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

Yes

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.

FCRA Disclosure and 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

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

User Requested Copy

User requested a copy to be sent to this

email address

*****************@*****.***.

Yes

DISCLOSURE AND AUTHORIZATION REGARDING BACKGROUND

INVESTIGATION FOR EMPLOYMENT PURPOSES

Disclosure

Riverside Transport Inc., Riverside Transportation LLC, Riverside Transportation Inc., RTI Dedicated LLC, Mid American Specialized Trucking LLC (the "Company") and/or Asurint may request from a consumer reporting agency and for employment-related purposes, a

"consumer report(s)" (commonly known as "background reports") containing background information about you in connection with your employment or application for employment (including independent contractor or volunteer assignments, as applicable). Asurint, Inc. ("Asurint") will prepare or assemble the background reports for the Company. Asurint is located and can be contacted at 3349 Michelson Drive, Suite 150, Irvine, CA 92612, 800-***-****, www.asurint.com. The background report(s) may contain information concerning your character, general reputation, personal characteristics, mode of living, or credit standing. The types of background information that may be obtained include, but are not limited to: criminal history; litigation history; motor vehicle record and accident history; social security number verification; address and alias history; credit history; verification of your education, employment and earnings history; professional licensing, credential and certification checks; drug/alcohol testing results and history; military service; and other information.

Authorization

I hereby authorize Company to obtain the consumer reports described above about me. Printed Name:

Anthony Kewann Williams

Social Security #:

0421

Signed Date: 05-24-2023

Anthony Kewann Williams

123 N Martin Luther King Dr

Hayti, MO 63851

573-***-****

Gender:

IMPORTANT DISCLOSURE

REGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with Riverside Transport Inc., Riverside Transportation LLC, Riverside Transportation Inc., RTI Dedicated LLC, Mid American Specialized Trucking LLC ("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 Riverside Transport Inc., Riverside Transportation LLC, Riverside Transportation Inc., RTI Dedicated LLC, Mid American Specialized Trucking LLC ("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:

Anthony Kewann Williams

Signed Date: 05-24-2023

Consent for Limited Queries of the Federal Motor Carrier Safety Administration (FMCSA) Drug and Alcohol Clearinghouse

I hereby provide consent to Riverside Transportation 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 Riverside Transportation 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 Riverside Transportation Inc to conduct a limited query of the Clearinghouse, Riverside Transportation 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 Riverside Transportation Inc indicates that drug or alcohol information exists about me in the Clearinghouse, the FMCSA will not disclose that information to Riverside Transportation Inc unless I give additional specific consent within the Clearinghouse. However, I understand that Riverside Transportation 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.

05-24-2023

Anthony Kewann Williams Date

DISCLOSURE AND AUTHORIZATION REGARDING BACKGROUND

INVESTIGATION FOR EMPLOYMENT PURPOSES

Disclosure

Authorization

I hereby authorize Company to obtain the consumer reports described above about me. Employer / Contractor / Educational Institution:

SMTDS

Printed Name:

Anthony Kewann Williams

Social Security #:

0421

Signed Date: 05-24-2023

Anthony Kewann Williams

123 N Martin Luther King Dr

Hayti, MO 63851

573-***-****

Gender:

A Summary of Your Rights Under the Fair Credit Reporting Act Para informacion en espanol, visite www.consumerfinance.gov/learnmore o escribe a la Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

A Summary of Your Rights Under the Fair Credit Reporting Act The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552. You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment - or to take another adverse action against you - must tell you, and must give you the name, address, and phone number of the agency that provided the information.

You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your "file disclosure"). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:

a person has taken adverse action against you because of information in your credit report;

you are the victim of identity theft and place a fraud alert in your file;

your file contains inaccurate information as a result of fraud;

you are on public assistance;

you are unemployed but expect to apply for employment within 60 days. In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for additional information.

You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.

You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.

Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete, or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.

Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.

Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need - usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.

You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.consumerfinance.gov/learnmore.

You may limit "prescreened" offers of credit and insurance you get based on information in your credit report. Unsolicited "prescreened" offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address form the lists these offers are based on. You may opt out with the nationwide credit bureaus at 1-888-5-OPTOUT (1-888-***-****).

The following FCRA right applies with respect to nationwide consumer reporting agencies: CONSUMERS HAVE THE RIGHT TO OBTAIN A SECURITY FREEZE You have a right to place a "security freeze" on your credit report, which will prohibit a consumer reporting agency from releasing information in your credit report without your express authorization. The security freeze is designed to prevent credit, loans, and services from being approved in your name without your consent. However, you should be aware that using a security freeze to take control over who gets access to the personal and financial information in your credit report may delay, interfere with, or prohibit the timely approval of any subsequent request or application you make regarding a new loan, credit, mortgage, or any other account involving the extension of credit. As an alternative to a security freeze, you have the right to place an initial or extended fraud alert on your credit file at no cost. An initial fraud alert is a 1-year alert that is placed on a consumer's credit file. Upon seeing a fraud alert display on a consumer's credit file, a business is required to take steps to verify the consumer's identity before extending new credit. If you are a victim of identity theft, you are entitled to an extended fraud alert, which is a fraud alert lasting 7 years. A security freeze does not apply to a person or entity, or its affiliates, or collection agencies acting on behalf of the person or entity, with which you have an existing account that requests information in your credit report for the purposes of reviewing or collecting the account. Reviewing the account includes activities related to account maintenance, monitoring, credit line increases, and account upgrades and enhancements.

You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.

Identity theft victims and active duty military personnel have additional rights. For more information, visit www.consumerfinance.gov/learnmore.

States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. For information about your federal rights, contact: TYPE OF BUSINESS: CONTACT:

1.a. Banks, savings associations, and credit unions with total assets of over $10 billion and their affiliates

b. Such affiliates that are not banks, savings associations, or credit unions also should list, in addition to the CFPB: a. Consumer Financial Protection Bureau

1700 G Street, N.W.

Washington, DC 20552

b. Federal Trade Commission

Consumer Response Center

600 Pennsylvania Avenue, N.W.

Washington, DC 20580

877-***-****

2. To the extent not included in item 1 above:

a. National banks, federal savings associations, and federal branches and federal agencies of foreign banks

b. State member banks, branches and agencies of foreign banks

(other than federal branches, federal agencies, and Insured State Branches of Foreign Banks), commercial lending companies owned or controlled by foreign banks, and organizations operating under section 25 or 25A of the Federal Reserve Act.

c. Nonmember Insured Banks, Insured State Branches of Foreign Banks, and insured state savings associations d. Federal Credit Unions

a. Office of the Comptroller of the Currency

Customer Assistance Group

1301 McKinney Street, Suite 3450

Houston, TX 77010-9050

b. Federal Reserve Consumer Help Center

P.O. Box 1200

Minneapolis, MN 55480

c. FDIC Consumer Response Center

1100 Walnut Street, Box #11

Kansas City, MO 64106

d. National Credit Union Administration

Office of Consumer Financial Protection (OCFP)

Division of Consumer Compliance Policy and Outreach 1775 Duke Street

Alexandria, VA 22314

3. Air Carriers Asst. General Counsel for Aviation Enforcement & Proceedings Aviation Consumer Protection Division

Department of Transportation

1200 New Jersey Avenue, S.E.

Washington, DC 20590

4. Creditors Subject to the Surface Transportation Board Office of Proceedings, Surface Transportation Board Department of Transportation

395 E Street, S.W.

Washington, DC 20423

5. Creditors Subject to the Packers and Stockyards Act, 1921 Nearest Packers and Stockyards Administration area supervisor 6. Small Business Investment Companies Associate Deputy Administrator for Capital Access United States Small Business Administration

409 Third Street, S.W., Suite 8200

Washington, DC 20416

7. Brokers and Dealers Securities and Exchange Commission 100 F Street, N.E.

Washington, DC 20549

8. Federal Land Banks, Federal Land Bank Associations, Federal Intermediate Credit Banks, and Production Credit Associations

Farm Credit Administration

1501 Farm Credit Drive

McLean, VA 22102-5090

9. Retailers, Finance Companies, and All Other Creditors Not Listed Above

Federal Trade Commission

Consumer Response Center

600 Pennsylvania Avenue, N.W.

Contact this candidate