Transport, LTL, FTL, Trucking, crossdocking, warehousing in NJ, Dallas, Memphis, TN, TX

Applicant Information

First Name *

Last Name *

SSN *

Date of Birth *

Street Address *

Street Address Line 2 *

City *

State / Province *

Postal / Zip Code *

Country *

Phone Number *

Cell Phone *

E-mail *

Select preferred method of contact *

Best time to contact you

How did you hear about us?

Do you have 12 months OTR experience? *

Yes No

Have you driven in the last 2 years? *

Yes No

Drivers' License Number *

CDL Issue State *

Past Employer Details

Employer Name *

Start Date *

End Date *

Street Address *

Street Address Line 2 *

City *

State / Province *

Postal / Zip Code *

Phone Number *

Position Held *

Type of Equipment *

Is this your current employer? *

Yes No

May we contact this employer *

Yes No

Reason for leaving *

Was this a driving position? *

Yes No

To be read and signed by Applicant

Completing this application is a step in the process of getting hired to drive for DNG Transport, LLC. 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.

Your Signature *

Safety Performance History-Records Request - Drug/Alcohol Testing

I, ( , , ) hereby authorize my previous employer to release and forward the information requested below concerning my Alcohol and Controlled Substance Testing records within the previous three (3) years from the date of my employment application. The information should be sent to my prospective employer DNG Transport,LLC

Previous Employer Name *

Previous Employer Name Additional

Your Signature *

Motor Vehicle Record Request Form

I would like to request you to order a Motor Vehicle Record (MVR) for the following individual:

Drivers' License Number *

State *

Date of Birth *

Years of experience *

Individual: I understand that driving is a part of my job description, and I hereby give permission to DNG Transport, LLC. to access my motor vehicle records.

Your Signature *

Disclosure regarding background reports from the PSP Online Service

In connection with your application for employment with DNG Transport 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 DNG Transport, 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.

Your Signature *

Print Name First Name *

Print Name Last Name *

Today

NOTICE: This form is made available to monthly account holders by NIC on behalf of the U.S. Department of Transportation, Federal Motor Carrier Safety Administration (FMCSA). Account holders are required by federal law to obtain an Applicant’s written or electronic consent prior to accessing the Applicant’s PSP report. Further, account holders are required by FMCSA to use the language contained in this Disclosure and Authorization form to obtain an Applicant’s consent. The language must be used in whole, exactly as provided. Further, the language on this form must exist as one stand-alone document. The language may NOT be included with other consent forms or any other language

NOTICE: The prospective employment concept referenced in this form contemplates the definition of “employee” contained at 49 C.F.R. 383.5.

Customer Information

Shipment details

Customer Information

Product details

Career

DNG TRANSPORT LLC

Applicant Information

Past Employer Details

To be read and signed by Applicant

Safety Performance History-Records Request - Drug/Alcohol Testing

Motor Vehicle Record Request Form

Disclosure regarding background reports from the PSP Online Service

AUTHORIZATION