Application for Employment Truck Drivers

SunOne Logistics uses E-Verify SunOne Logistics is a Division of Sunbelt Forest Products

SunOne Logistics Location: 348 Baxley Hwy, Hazlehurst, GA 31539

Prospective employees will receive consideration without discrimination because of race, color, creed, sex, age, national origin, handicap, or veteran status.
Candidates for employment will be subject to testing to determine the presence of illegal controlled substance(s) in their system based on FMCSR 382.301.

1Personal Information

2Driver Experience and Qualifications

3Employment History

Today's Date : March 22, 2023
Personal Information
First
Middle
Last
Phone
Email
DOT Requires Date of Birth
Present Address
Number
Street
Apt#
City
State
Zip Code
How long at this address?
Truck Driving Application - requires a list of residency for the past 3 years.
Previous Address

Previous Address

Number	Street	Apt#	City	State	Zip Code	How Long?
							Edit Delete
There are no Previous Address.

Maximum number of previous address reached.

Have you ever worked for this company before?
Where?
When?
Have you ever been convicted of a felony?
(Note: a felony conviction is not an absolute bar to employment)
If yes, please explain
Is there any reason you might be unable to perform the essential functions of the job for which you have applied
If yes, please explain
Education

Education

Education Type	School Name	Last Year Completed	Degree or Certificate	What areas:
					Edit Delete
There are no Education.

Maximum number of education reached.

Driver Experience and Qualifications
List each unexpired commercial motor vehicle operator’s license or permit that has been issued to you.

Driver’s License(s)
State
License No.
Type
Expiration Date
MM slash DD slash YYYY
A. Have you ever been denied a license, permit or privilege to operate a motor vehicle?
B. Have you had a license, permit or privilege suspended or revoked?
C. Have you ever been disqualified as a driver?
D. Have you ever failed or refused a pre-employment drug or alcohol test at a company where you ever took employment?
(If yes, please provide proof that you have successfully completed the return-to-duty process as described in 382.309 of the FMCSR.)
If the answer to either A, B, C, or D is yes, please explain for each
Driving Experience
Class of Equipment

Class of Equipment

Vehicles:	Date:	How Long?	Miles Operated:
				Edit Delete
There are no Class of Equipment.

Maximum number of class of equipment reached.

List the states operated in during the past 5 years
List special courses or training attended which pertains to driving
List driving awards held and presenting organization
Failure to disclose information may prevent this applicant a position or terminated if information is found out in the future if the applicant is hired
Accident Review for the Past 3 Years

Last Accident
Date
Nature of Accident (Head-on, Rear-end, Upset, Etc…)
Fatalities
Injuries
Previous Accident(s)

Previous Accident

Date	Nature of Accident (Head-on, Rear-end, Upset, Etc…)	Fatalities	Injuries
				Edit Delete
There are no Previous Accident.

Maximum number of previous accident reached.

Traffic Convictions and Forfeitures for the Past 3 Years
1st Year

Traffic Convictions and Forfeitures

Year (1st, 2nd, 3rd etc.)	Date	Location	Charge	Penalty
					Edit Delete
There are no Traffic Convictions and Forfeitures.

Maximum number of traffic convictions and forfeitures reached.

Employment History

Here at SunOne Logistics, we can not say that you will never cross the state line. We will require a list of employment for the previous 10 years, including jobs held while in school or in the military. (All driver applicants to drive interstate commerce must provide the following information on all employers during the preceding 3 years. Applicants to drive a commercial motor vehicle* in intrastate commerce shall also provide an additional 7 years of information on those employers for whom the applicant operated such vehicle.)

(NOTE: list employers starting with the most recent. Add another sheet as necessary.)

Employment History

Name	Location	From	To	Were you subject to the FMCSA while employed?	Salary	Why did you leave?	Supervisor’s Name, Title, and Phone Number (if accessible)	May we contact?
									Edit Delete
There are no Employment.

Maximum number of employment reached.

*Includes vehicles that have a GVWR of 26,001 lbs. or more, vehicles designed to transport 15 or more passengers, or any size vehicle used to transport hazardous materials in quantity requiring placarding.

I certify that I have read and understood this employment application in its entirety. It is agreed and understood that the employer or his agents may investigate my background to ascertain any and all information of concern to my employment history and I release employers and other persons named herein from all liability for any damages on account of furnishing such information. I understand that, as an applicant for a position with this company, I may be asked to demonstrate that I am capable of performing tasks which are pertinent to the job. I also understand that if offered a job, it may be conditioned on the results of the information collected, driving test, DOT physical exam, and drug test.

I further certify that I am a genuine applicant for employment and this application is being submitted solely for the purpose of seeking employment with the employer and for no other reason.

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 investigative Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living.

I agree to furnish such additional information and complete such examinations as may be required to complete my employment file.

I also understand that misrepresentation or omission of information or facts may result in my rejection or dismissal!

If hired, I agree to abide by all rules and policies of the employer and the FMCSA.

I certify the answers by me are full, complete, and true. I understand if employed, any misstatement or omission of fact on this application shall be considered cause for dismissal.
Signature
Date
MM slash DD slash YYYY
Hidden
FOR OFFICE USE
Hidden
Dept.
Hidden
Position
Hidden
Hire Date
Hidden
Rate
Hidden
Rate
Hidden
Approval
Hidden
Comment
Request for Check of Driving Record
I hereby authorize you to release the following information to SunOne Logistics, Inc. for purposes of investigation as required by Sections 391.23 and 391.25 of the Federal Motor Carrier Safety Regulations. You are released from any and all liability which may result from furnishing such information.
Applicant’s Signature Date
Date
MM slash DD slash YYYY
In accordance with the provisions of Sections 604 and 607 of the Fair Credit Reporting Act, Public Law 91-508, as amended by the Consumer Credit Reporting Act of 1996 (Title II, Subtitle D, Chapter 1 of Public Law 104-208), I hereby certify the following:
1. The consumer (applicant) has authorized in writing the procurement of this report;
2. The consumer (applicant) has been informed in a separate written disclosure that a consumer report may be obtained for employment purposes;
3. The information requested below will be used for a “permissible purpose” (i.e. information for employment purposes) and will be used for no other purpose;
4. The information being obtained will not be used in violation of any federal or state equal opportunity law or regulation; and
5. Before taking an adverse action based in whole or in part on the report the consumer (applicant) will receive a copy of the requested report and the summary of consumer rights as provided with the report by the consumer reporting agency.
I also herby certify that this report request and the above applicant’s release notice meet the definition of “permissible uses” of state motor vehicle records under the provisions of the Driver’s Privacy Protection Act of 1994 (Public Law 103-322, Title XXX, Sections 300002(a)).
(Signature of Requester)
Date
MM slash DD slash YYYY
THE BELOW DISCLOSURE AND AUTHORIZATION LANGUAGE IS FOR MANDATORY USE BY ALL ACCOUNT HOLDERS

IMPORTANT DISCLOSURE REGARDING BACKGROUND REPORTS FROM THE PSP Online Service
In connection with your application for employment with _SunOne Logistics, 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 __SunOne Logistics, 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.
Date
MM slash DD slash YYYY
Name (Please Print)
Signature
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. 983.5. LAST UPDATED 12/22/2017
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Application for Employment Truck Drivers

Personal Information

Present Address

Truck Driving Application - requires a list of residency for the past 3 years.

Previous Address

Education

Driver Experience and Qualifications

List each unexpired commercial motor vehicle operator’s license or permit that has been issued to you.

Driver’s License(s)

Driving Experience

Class of Equipment

Failure to disclose information may prevent this applicant a position or terminated if information is found out in the future if the applicant is hired

Accident Review for the Past 3 Years

Last Accident

Previous Accident(s)

Traffic Convictions and Forfeitures for the Past 3 Years

1st Year

Employment History

FOR OFFICE USE

Request for Check of Driving Record

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