Stevens Transport, Inc. (Stu)
Dallas, TX 75227
**-**-**** *:22:21PM CDT
IntelliApp (Stu)
Thank you for your interest in Stevens Transport, Inc.. To apply for a driving position, please complete our qualification form. Incomplete information will delay processing of your qualification form or prevent it from being submitted. In compliance with Federal and State equal employment opportunity laws, qualified candidate 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: TATDS
Name Bret Adam Gundy
Residence 3 years or longer (If No,
previous addresses shown below)
No
Current Address 31415 Bugle Ln.
City, State/Province Zip/Postal Wesley Chapel, Fl 33543 Country
Addresses Over last 3 years Address 1
1180 Old Johnson Rd.
Cowpens, SC 29330
United States
10-2021 to 05-2022
Address 2
31415 Bugle Ln.
Wesley Chapel, FL 33543
United States
09-1994 to 10-2021
SSN/SIN 6825
Date of Birth
Primary Phone 813-***-****
Email adxkh4@r.postjobfree.com
Yes, I agree to receive information
concerning future opportunities or
promotions from Stevens Transport, Inc.
(Stu) by email or other commercial
electronic communications.
Yes
Yes
1
Would you like to receive communication
from Stevens Transport, Inc. (Stu) 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 Stevens
Transport, Inc. (Stu)'s service provider
receives in real time and logs your text
messages with Stevens Transport, Inc.
(Stu).
Company Questions
Driver Record
Do you have any CDL class A driving
experience?
No
Driver Type: Looking for CDL school training
Haz-Mat endorsement? No
CDL Permit? No
What is your immigration status? Citzen
Have you ever served in the military? No
Are you currently attending truck driving
school?
No
Did you graduate within the past 6
months?
No
Ever tested positive or refused a
pre-employment drug or alcohol test?
No
How many times?
Have you had any tickets in the last 3
years?
No
Number of tickets in last 3 years:
When and what were the tickets?
Have you had any accidents in the last 3
years?
No
Number of accidents in the last 3 years:
Amount of damage in dollars:
How many were your fault?
Driver Record 2
Has your license ever been suspended or
revoked?
No
If yes, when?
Why?
How did you hear about Stevens Transport?
Please choose one: Careerbuilder.com
Student Drivers: Referred by Recruiter
Name of Recruiter (if chosen above):
Other (if chosen above): Troy
Personal Reference
Name:
Relationship:
Phone:
Licenses
License Number 070
Licensing Authority SC
Country US
License Class
License Expiration Date 10-20-2029
Current License Yes
Commercial Driver License No
Endorsements None
Employment / Unemployment
Adidas warehouse
Company Adidas warehouse
Contact / Supervisor Name
Start Date 10-2021
End Date 05-2023
Address
City, State/Province Zip/Postal Spartenburg, SC 29330 Country United States
Phone 800-***-****
How did you hear about Stevens Transport? 3
Position Held Warehouse
Reason for leaving? Moved back to Florida
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 subject to drug and
alcohol testing?
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Unemployment
Start Date 04-2021
End Date 09-2021
Comment I was looking for a job during this time
period.
Advanced Auto Parts and Batteries
Company Advanced Auto Parts and Batteries
Contact / Supervisor Name
Start Date 05-2016
End Date 03-2021
Address 27270 S.R. 54
City, State/Province Zip/Postal Wesley Chapel, FL 33544 Country United States
Phone 813-***-****
Position Held Parts pro
Reason for leaving? Moved to South Carolina
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? Yes
Personal Reference 4
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?
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Wal Mart
Company Wal Mart
Contact / Supervisor Name
Start Date 06-2012
End Date 04-2016
Address 7631 Gall Blvd.
City, State/Province Zip/Postal Zephyrhills, FL 33541 Country United States
Phone 813-***-****
Position Held Electronics
Reason for leaving? They wouldn't move me to another wal mart closer to home.
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 subject to drug and
alcohol testing?
Pay Range (cents/mile)
Personal Reference 5
Most common truck driven
Most common trailer
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
Have you ever been arrested for driving
while intoxicated?
No
When?
How many times in the past 5 years?
How many times total?
Have you ever been charged with a crime? No
When?
What were you convicted or charged with?
Type of charge? (felony or misdemeanor)
Signature
Full Name Bret Adam Gundy
IP Address 2607:fb91:8c0e:c
Signature Date/Time 05-01-2023 4:22 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.
Personal Reference 6
Signed Date: 05-01-2023 4:22 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
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 and Authorization
By my check of this box, I represent that I
understand and agree to the above and
that I intend to execute this document by
electronic 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
Personal Reference 7
User Requested Copy
User requested a copy to be sent to this
email address adxkh4@r.postjobfree.com.
Yes
Personal Reference 8
DISCLOSURE NOTICE AND AUTHORIZATION
REGARDING BACKGROUND CONSUMER REPORTS
Important - Please read carefully before signing below. I. NOTICE:
In connection with my application for employment, I understand that STEVENS TRANSPORT, INC., ("Stevens") may request and obtain consumer reports or investigative consumer reports which may contain such information of me, including but not limited to my prior employment history and verifications, criminal history, military record, education, credit history, driving record, results of prior drug tests and information related to my character, reputation or mode of living. I understand that an investigative consumer report may include information obtained through personal interviews with neighbors, friends or associates with whom I am acquainted. These consumer reports and/or investigative consumer reports may be obtained at any time during the application process or during my employment with Stevens Transport, Inc.
I understand that I may make a written request to STEVENS' HUMAN RESOURCES DEPARTMENT for a complete and accurate disclosure of the nature and scope of the investigation requested and the name and telephone number of the reporting agency. Upon receiving such notice, Stevens will provide this disclosure in writing mailed or otherwise delivered to me not later than five (5) business days after the date on which the request for such disclosure was received from the consumer or such report was first requested, whichever is later. II. AUTHORIZATION:
By signing below, I AUTHORIZE Stevens to obtain a consumer report and/or investigative consumer report on me as part of its background investigation process. If I am offered employment by Stevens, I further authorize Stevens to obtain additional consumer reports and/or investigative consumer reports on me for employment purposes at any time during my employment.
I further authorize any present or former employer, school, police department, financial institution, division of motor vehicles, consumer reporting agency, court, department of corrections and any other person or agency having knowledge about me to furnish Stevens or its authorized vendor or representative any and all information regarding my background in their possession, custody or control.
By signing, I acknowledge that Stevens has provided me with a summary of my rights under the Fair Credit Reporting Act. I further represent that the information provided below is true, accurate and complete. READ, ACKNOWLEDGED AND AUTHORIZED
Printed Name:
Bret Adam Gundy
Social Security #:
6825
Signed Date: 05-01-2023
Bret Adam Gundy
31415 Bugle Ln.
Wesley Chapel, Fl 33543
Gender:
Personal Reference 9
IMPORTANT DISCLOSURE
REGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with Stevens Transport, 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 Stevens Transport, 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:
Bret Adam Gundy
Signed Date: 05-01-2023
Personal Reference 10
DISCLOSURE NOTICE AND AUTHORIZATION
REGARDING BACKGROUND CONSUMER REPORTS
Important - Please read carefully before signing below. I. NOTICE:
In connection with my application for employment, I understand that STEVENS TRANSPORT, INC., ("Stevens") may request and obtain consumer reports or investigative consumer reports which may contain such information of me, including but not limited to my prior employment history and verifications, criminal history, military record, education, credit history, driving record, results of prior drug tests and information related to my character, reputation or mode of living. I understand that an investigative consumer report may include information obtained through personal interviews with neighbors, friends or associates with whom I am acquainted. These consumer reports and/or investigative consumer reports may be obtained at any time during the application process or during my employment with Stevens Transport, Inc.
I understand that I may make a written request to STEVENS' HUMAN RESOURCES DEPARTMENT for a complete and accurate disclosure of the nature and scope of the investigation requested and the name and telephone number of the reporting agency. Upon receiving such notice, Stevens will provide this disclosure in writing mailed or otherwise delivered to me not later than five (5) business days after the date on which the request for such disclosure was received from the consumer or such report was first requested, whichever is later. II. AUTHORIZATION:
By signing below, I AUTHORIZE Stevens to obtain a consumer report and/or investigative consumer report on me as part of its background investigation process. If I am offered employment by Stevens, I further authorize Stevens to obtain additional consumer reports and/or investigative consumer reports on me for employment purposes at any time during my employment.
I further authorize any present or former employer, school, police department, financial institution, division of motor vehicles, consumer reporting agency, court, department of corrections and any other person or agency having knowledge about me to furnish Stevens or its authorized vendor or representative any and all information regarding my background in their possession, custody or control.
By signing, I acknowledge that Stevens has provided me with a summary of my rights under the Fair Credit Reporting Act. I further represent that the information provided below is true, accurate and complete. READ, ACKNOWLEDGED AND AUTHORIZED
Personal Reference 11
Employer / Contractor / Educational Institution:
Adidas warehouse
Printed Name:
Bret Adam Gundy
Social Security #:
6825
Signed Date: 05-01-2023
Bret Adam Gundy
31415 Bugle Ln.
Wesley Chapel, Fl 33543
Gender:
Personal Reference 12
DISCLOSURE NOTICE AND AUTHORIZATION
REGARDING BACKGROUND CONSUMER REPORTS
Important - Please read carefully before signing below. I. NOTICE:
In connection with my application for employment, I understand that STEVENS TRANSPORT, INC., ("Stevens") may request and obtain consumer reports or investigative consumer reports which may contain such information of me, including but not limited to my prior employment history and verifications, criminal history, military record, education, credit history, driving record, results of prior drug tests and information related to my character, reputation or mode of living. I understand that an investigative consumer report may include information obtained through personal interviews with neighbors, friends or associates with whom I am acquainted. These consumer reports and/or investigative consumer reports may be obtained at any time during the application process or during my employment with Stevens Transport, Inc.
I understand that I may make a written request to STEVENS' HUMAN RESOURCES DEPARTMENT for a complete and accurate disclosure of the nature and scope of the investigation requested and the name and telephone number of the reporting agency. Upon receiving such notice, Stevens will provide this disclosure in writing mailed or otherwise delivered to me not later than five (5) business days after the date on which the request for such disclosure was received from the consumer or such report was first requested, whichever is later. II. AUTHORIZATION:
By signing below, I AUTHORIZE Stevens to obtain a consumer report and/or investigative consumer report on me as part of its background investigation process. If I am offered employment by Stevens, I further authorize Stevens to obtain additional consumer reports and/or investigative consumer reports on me for employment purposes at any time during my employment.
I further authorize any present or former employer, school, police department, financial institution, division of motor vehicles, consumer reporting agency, court, department of corrections and any other person or agency having knowledge about me to furnish Stevens or its authorized vendor or representative any and all information regarding my background in their possession, custody or control.
By signing, I acknowledge that Stevens has provided me with a summary of my rights under the Fair Credit Reporting Act. I further represent that the information provided below is true, accurate and complete. READ, ACKNOWLEDGED AND AUTHORIZED
Personal Reference 13
Employer / Contractor / Educational Institution:
Advanced Auto Parts and Batteries
Printed Name:
Bret Adam Gundy
Social Security #:
6825
Signed Date: 05-01-2023
Bret Adam Gundy
31415 Bugle Ln.
Wesley Chapel, Fl 33543
Gender:
Personal Reference 14
DISCLOSURE NOTICE AND AUTHORIZATION
REGARDING BACKGROUND CONSUMER REPORTS
Important - Please read carefully before signing below. I. NOTICE:
In connection with my application for employment, I understand that STEVENS TRANSPORT, INC., ("Stevens") may request and obtain consumer reports or investigative consumer reports which may contain such information of me, including but not limited to my prior employment history and verifications, criminal history, military record, education, credit history, driving record, results of prior drug tests and information related to my character, reputation or mode of living. I understand that an investigative consumer report may include information obtained through personal interviews with neighbors, friends or associates with whom I am acquainted. These consumer reports and/or investigative consumer reports may be obtained at any time during the application process or during my employment with Stevens Transport, Inc.
I understand that I may make a written request to STEVENS' HUMAN RESOURCES DEPARTMENT for a complete and accurate disclosure of the nature and scope of the investigation requested and the name and telephone number of the reporting agency. Upon receiving such notice, Stevens will provide this disclosure in writing mailed or otherwise delivered to me not later than five (5) business days after the date on which the request for such disclosure was received from the consumer or such report was first requested, whichever is later. II. AUTHORIZATION:
By signing below, I AUTHORIZE Stevens to obtain a consumer report and/or investigative consumer report on me as part of its background investigation process. If I am offered employment by Stevens, I further authorize Stevens to obtain additional consumer reports and/or investigative consumer reports on me for employment purposes at any time during my employment.
I further authorize any present or former employer, school, police department, financial institution, division of motor vehicles, consumer reporting agency, court, department of corrections and any other person or agency having knowledge about me to furnish Stevens or its authorized vendor or representative any and all information regarding my background in their possession, custody or control.
By signing, I acknowledge that Stevens has provided me with a summary of my rights under the Fair Credit Reporting Act. I further represent that the information provided below is true, accurate and complete. READ, ACKNOWLEDGED AND AUTHORIZED
Personal Reference 15
Employer / Contractor / Educational Institution:
Wal Mart
Printed Name:
Bret Adam Gundy
Social Security #:
6825
Signed Date: 05-01-2023
Bret Adam Gundy
31415 Bugle Ln.
Wesley Chapel, Fl 33543
Gender:
Personal Reference 16
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