Background Screening Report - Single Item

**** * ***** **** *** SUITE 127.

TULSA, OK 74134-5801

Telephone: 877-***-****

Fax: 918-***-****

From Case Number: 30788282

Candidate: Still, Keith Robert

CANDIDATE INFORMATION

Prepared For: Lazer Spot, Inc

State of Arizona

Candidate's Address:

XXX-XX-7525

14235 W Piccadilly Rd

Goodyear, AZ 85395

UNITED STATES

DOB: 07/03/1950

SSN:

SUMMARY OF FULL INVESTIGATION

Request Completed Element Type Description Status

SUPPLEMENTAL SEX OFFENDER REG. - STILL,

KEITH

09/06/2023 09/06/2023 SUPPL SEX OFF. REG. Clear

09/06/2023 09/06/2023 SUPP CRIM DATABASE SUPP CRIM DATABASE - STILL, KEITH ROBERT Complete 09/06/2023 09/06/2023 MOTOR VEHICLE RECORD * STATE OF ARIZONA Complete

.

Reference 1:

Recruiter: Jayna Baldwin

Work List: Tolleson AZ 3102517

RequestID: 6004985

Candidate_ID: 102639344

Ordering_User: Jayna Baldwin

Email : adzmm0@r.postjobfree.com

Phone : 623-***-****

Case Comments:

* Detail is only included for items underlined in the summary. See a Full Case Report or alternate "single Item" documents for other detail. Status Definitions

Adverse The report component is complete and includes discrepant or negative information. Clear Clear, no review required.

Complete Complete and ready for review.

Error The report component could not be completed due to incorrect input of information. Needs Review The report is complete, however, the component contains information that should be reviewed. NotPursued Lead intentionally closed before research completed. Pending Lead still being researched.

See Detail Results are neither clear nor adverse for this component. Refer to "Investigative Detail" pages for more information.

*** END OF REPORT ***

Case No.: 30788282 Page 1

Printed: 09/06/2023 16:33:08 Still, Keith Robert

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STILL, KEITH

Case No. 30788282

LICENSE D01627997

NAME Still, Keith

STATE AZ

CLASS

A CLASS A COMMERCIAL COMB VEH > 26K WITH TRAILERS > 10K ENDORSEMENTS DOUBLE TRIPLES DT

RESTRICTIONS:

NOTES: LIC STATE AZ

CLASS

D CLASS D NON COMMERCIAL ANY NON COMMERCIAL VEHICLES ENDORSEMENTS MOTORCYCLE M1

RESTRICTIONS:

NOTES: LIC STATE AZ

ATTRIBUTE: VOLUNTARY TRAVELV VETERAN

STATUS CERTIFIED

STATE DEFINED

MOTOR VEHICLE RECORD

JURISDICTION

AZ

SUMMARY

Complete As of 09/06/2023

PROVIDED BY CLIENT

INFORMATION RETURNED FROM STATE

NAME / ADDRESS PHYSICAL IDENTITY

STILL, KEITH, ROBERT

14235 W PICCADILLY AVE,

Goodyear AZ 85395 8436

PREV:14235 W PICCADILLY RD,

Goodyear AZ 85395

HEIGHT

5'10

WEIGHT

249 Lbs

SEX

M

EYE

HAZEL

HR

GRY

DOB

07/03/1950

SSN

XXX XX XXXX

LICENSE D01627997

TYPE DETAILS STATUS ISSUED EXPIRES

COMMERCIAL VALID 05/24/2023 10/07/2027

PERSONAL VALID 05/24/2023 10/07/2027

MEDICAL

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STATUS

RECEIVED BY DMV

ISSUED

EXPIRES

SELF CERTIFICATION:

STATE DESCRIPTION

COMMERCIAL PRIVILEGES ONLY FAILED TO SUBMIT USDOT MEDICAL EXAM REPORTS

ADDITIONAL

MESSAGES

STATE DESCRIPTION

COMMERCIAL PRIVILEGES ONLY FAILED TO SUBMIT USDOT MEDICAL EXAM REPORTS

ACD CODE W82

STATE OFFENSE CODE 28 3314

STATE DESCRIPTION

COMMERCIAL PRIVILEGES ONLY FAILED TO SUBMIT USDOT MEDICAL EXAM REPORTS

ACD CODE W82

STATE OFFENSE CODE 28 3314

START DATE 06/03/2021

MAIL DATE 06/03/2021

ACTIONTYPE VIOL

ACTIONCODE SUSP

DESCRIPTION SUSPENSIONSUSPENSION

ADDITIONAL

MESSAGES

VIOLATIONS

VIOLATION

DATE

DISPOSITION

DATE

NOTES STATE ACD

CODE

STATE

CODE

PTS

06/02/2021 / / COMMERCIAL PRIVILEGES ONLY FAILED TO SUBMIT USD AZ W82 28 3314

OTHER EVENTS

TYPE OCCURRED REINSTATEMENT

DATE

NOTES REPORT

NUMBER

VIOLATIONS 06/03/2021 06/07/2021 COMMERCIAL PRIVILEGES ONLY FAILED TO SUBMIT USD Printed on: 09/06/2023 16:33:09 Still, Keith

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TYPE OCCURRED REINSTATEMENT

DATE

NOTES REPORT

NUMBER

STATE AUTHORITY CODE: 28 3314 STATUS: COMPLETED

CLEAR DATE 06/07/2021

NOTES

TOTAL STATE POINTS : 0

CDL Med Status: Medically Certified Meets Standard AKA

DISPLAY NAME: KEITH R STILL

DATE OF BIRTH: 07/03/1950

DRIVER LICENSE NUMBER: 7525

AKA

DISPLAY NAME: KEITH ROBERT STILL

DATE OF BIRTH: 07/03/1950

DRIVER LICENSE NUMBER: 7525

TSA HAZMAT STATUS: NO TSA INFORMATION AVAILABLE

ADDITIONAL LICENSES AND/OR PERMITS

CLASS A DRIVER LICENSE AZ #D01627997 ISS: 10/07/2019 EXP: 10/07/2027 STATUS: CANCELLED CLASS A DRIVER LICENSE AZ #D01627997 ISS: 05/09/2017 EXP: 07/03/2022 STATUS: CANCELLED CLASS A DRIVER LICENSE AZ #D01627997 ISS: 06/07/2012 EXP: 07/03/2017 STATUS: CANCELLED CLASS A DRIVER LICENSE AZ #D01627997 ISS: 05/27/2009 EXP: 07/03/2012 STATUS: CANCELLED CLASS A DRIVER LICENSE AZ #D01627997 ISS: 01/19/2007 EXP: 07/03/2012 STATUS: CANCELLED CLASS A DRIVER LICENSE AZ #D01627997 ISS: 06/27/2002 EXP: 07/03/2015 STATUS: CANCELLED CLASS A DRIVER LICENSE AZ #D01627997 ISS: 07/18/2001 EXP: 07/03/2015 STATUS: CANCELLED CLASS A DRIVER LICENSE AZ 7525 ISS: 06/25/1997 EXP: 07/03/2010 STATUS: CANCELLED CLASS A DRIVER LICENSE AZ 7525 ISS: 06/25/1997 EXP: 07/03/2015 STATUS: CANCELLED END OF REPORT

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