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AAA Trucking LLC

Driver Application

Apply to drive for AAA Trucking

This is the complete AAA Trucking LLC driver application — the same four forms as our paper/PDF packet, in the same order. Fill in one form, tap Continue, and the next form appears:

  1. Application for Employment — your information, driving experience, accident & conviction record, and 10-year employment history
  2. Release of Information — 49 CFR Part 40 — drug & alcohol testing records release (3 copies, one per previous employer)
  3. Safety Performance History — the full safety performance history form, plus the records request and rebuttal statement
  4. Correction Request — §391.23(j) request to correct erroneous safety performance history information

Fields marked * are required. Everything else can be left blank if it does not apply to you. Where a form says “signature,” type your full legal name.

When you finish all four forms, tap Finish & send by email. Your email app will open with the completed application addressed to hassan@aaatrucker.com — just press Send in your email app and your application is on its way to us.

Form 1 of 4

Application for Employment

AAA Trucking LLC · 8131 NE 51st, Kansas City, Missouri 64119

Your name & current address

Previous three years residency

License information

Section 383.21 FMCSR states “No person who operates a commercial motor vehicle shall at any time have more than one driver's license.” I certify that I do not have more than one motor vehicle license, the information for which is listed below.

Driving experience

Class of equipmentType of equipment (van, tank, flat, etc.)Dates — from / toApprox. no. of miles (total)
Straight Truck
Tractor and Semi-Trailer
Tractor — Two Trailers
Other

Accident record — past 3 years or more

Leave blank if you have had no accidents. Add any extra accidents in the “anything else” box at the end of this form.

Traffic convictions & forfeitures — past 3 years

Other than parking violations. Leave blank if none.

License history questions

A. Have you ever been denied a license, permit or privilege to operate a motor vehicle?
B. Has any license, permit or privilege ever been suspended or revoked?

Employment record — past 10 years

Applicants that desire to drive in intrastate/interstate commerce must provide the following information on all employers during the previous three years. You must give the same information for all employers you have driven a commercial motor vehicle for the seven years prior to the initial three years (total of ten years employment record). List the complete mailing address: street number and name, city, state and zip code.

Fill in as many employers as you have had — start with the most recent. Leave the rest blank.

To be read and signed by applicant

I authorize you to make sure investigations and inquiries to my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.

“I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:

  • Review information provided by current/previous employers;
  • Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and
  • Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.”

This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge.

Note: A motor carrier may require an applicant to provide information in addition to the information required by the Federal Motor Carrier Safety Regulations.

Form 2 of 4

Release of Information — 49 CFR Part 40 Drug & Alcohol Testing

There are 3 copies of this release — complete one copy for each previous employer. Section I (your part) is on every copy. Section II is completed by the previous employer after AAA Trucking sends them the copy, so it is included on each copy for them to fill in. If you had fewer than 3 previous employers, leave the extra copies blank.

Form 3 of 4

Safety Performance History Records Request

Part 1 is yours to complete. Parts 2, 3, 4a and 4b are completed by your previous employer and by AAA Trucking — they are included below so the complete form goes out as one packet, and the previous-employer sections can be left blank.

Part 1 — To be completed by prospective employee (you)

To release and forward the information requested by section 3 of this document concerning my Alcohol and Controlled Substances Testing records within the previous 3 years from the employment application date above.

In compliance with §40.25(g) and 391.23(h), release of this information must be made in a written form that ensures confidentiality, such as fax, email, or letter. This information is being requested in compliance with §40.25(g) and 391.23.

Part 2 — To be completed by previous employer

Accident history. The previous employer completes this part — leave blank unless you are filling it in for them.

The applicant named above was employed by us
1. Did he/she drive a motor vehicle for you?
If yes, what type? (check all that apply)
2. Reason for leaving your employ
History to report

Accidents (previous employer)

Complete for any accidents included on your accident register (§390.15(b)) that involved the applicant in the 3 years prior to the application date above.

Part 3 — To be completed by previous employer

Drug and alcohol history. In answering these questions, include any required DOT drug or alcohol testing information obtained from prior employers in the previous 3 years.

Driver was NOT subject to DOT testing requirements while employed by this employer

Part 4a — To be completed by prospective employer (AAA Trucking)

This form was (check one)

Part 4b — To be completed by prospective employer (AAA Trucking)

Complete when information is obtained.

Records Request for Driver/Applicant Safety Performance History

This request is made by the driver/applicant in compliance with the Department of Transportation regulations. §391.23(i)(2): Drivers who have previous DOT regulated employment history in the preceding three years, and wish to review previous employer-provided investigative information, must submit a written request to the prospective employer, which may be done at any time, including when applying, or as late as thirty (30) days after being employed or being notified of denial of employment. The prospective employer must provide this information to the applicant within five (5) business days of receiving the written request. If the prospective employer has not yet received the requested information from the previous employer(s), then the five-business-days deadline will begin when the prospective employer receives the requested safety-performance history information. If the driver has not arranged to pick up or receive the requested records within thirty (30) days of the prospective employer making them available, the prospective motor carrier may consider the driver to have waived his/her request to review the records.

Part 1 — Completed by the driver/applicant (you)

I am submitting this written request to obtain copies of my Department of Transportation Safety Performance History for the preceding three years. I understand, for records requested from a prospective employer, that I must arrange to pick up or receive the requested records within thirty (30) days of the records being made available or I have waived my request to review the records.

This information should be

Part 2 — Completed by the prospective employer (AAA Trucking)

The information must be provided to the applicant within five (5) business days of receiving the written request.

Rebuttal Statement

Under §391.23(j)(3), a driver may submit a rebuttal statement if the previous employer and the driver cannot agree on the accuracy of information in the driver's safety performance history. The previous employer must forward a copy of the rebuttal to the prospective motor carrier employer and append the rebuttal to the driver's information in the carrier's file, to be included as part of the response for any subsequent investigating prospective employers for the duration of the three-year data retention requirements.

If this does not apply to you, leave the statement blank — your name and address are still carried over from above.

Part 1 — Completed by the driver/applicant (you)

I have submitted this rebuttal to my previous employer requesting that it be attached to my Safety Performance History and provided to subsequent prospective employers.

Part 2 — Completed by the previous employer

Form 4 of 4

Correction Request of Erroneous Safety Performance History Information

This request is made by the driver/applicant in compliance with the Department of Transportation regulations, §391.23, investigations and inquiries, paragraphs (j)(1) and (2):

§391.23(j)(1) A driver wishing to request correction of erroneous information in records received pursuant to paragraph (i) of this section must send the request for the correction to the previous employer that provided the records to the prospective employer.

§391.23(j)(2) After October 29, 2004, the previous employer must either correct and forward the information to the prospective motor carrier employer, or notify the driver within 15 days of receiving a driver's request to correct the data that it does not agree to correct the data. If the previous employer corrects and forwards the data as requested, that employer must also retain the corrected information as part of the driver's safety performance history record and provide it to subsequent prospective employers when requests for this information are received. If the previous employer corrects the data and forwards it to the prospective motor carrier employer, there is no need to notify the driver.

If you have nothing to correct, you can leave the details blank — this form still goes in with your application, completed if and when you need it.

Part 1 — Completed by the driver/applicant (you)

I request correction of erroneous information in my Safety Performance History. Please forward to the following prospective employer:

Part 2 — Completed by the previous employer

Disposition of the requested information. Return copy 3 to the driver.

Information was corrected and forwarded to the prospective motor carrier employer

Part 3 — Completed by the prospective motor carrier employer

Last step

Review & send your application

Check the summary below. Use the steps at the top to go back and fix anything — nothing is sent until you press the email button and then press Send in your own email app.

The email button opens your email app (Gmail, Mail, Outlook, etc.) with the completed application already filled in and addressed to hassan@aaatrucker.com. Your application is only sent when you press Send in your email app. If the email comes out too long for your email app, use “Download a copy” and attach that file to an email to hassan@aaatrucker.com instead.