SS CHaD Express LLC

Application

Basic Info
Current Address
Previous Address
Previous Address
Education
Undergrad
Post-Grad
Employment History
Present or Last Employer
Previous Employer 1
Previous Employer 2
Previous Employer 3
Previous Employer 4
Driving Experience
Straight Truck
Tractor and Semi-trailer
Tractor two trailers
Tractor three trailers (Triples)
Other
Accident Record
Accident
Traffic Convictions
Traffic Conviction
Driver's License 1
*Disclosure of this information does not automatically exclude the driver from consideration.
Please use the following area if you have any additional comments.
It is agreed and understood that any misrepresentation given on this document shall be considered an act of dishonesty. It is agreed and understood that the motor carrier or his agents may investigate my background to ascertain any and all information of concern to commercial driving record, whether same is of record or not, and I release the employers and persons named herein from all liability for any damages on account of their furnishing such information. It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an investigating Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living. This certifies that the above information was completed by me, and that all entries on it and information are true and complete to the best of my knowledge.
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