Driver Application

Driver Application

First Name: Reinaldo

Last Name: Yen Rodriguez

Address: 201 w tarrant rd

City: Grand prairie

State: TX

ZIP Code: 75050

Cell Phone: 432-307-0526

Email Address: yenrey571@gmail.com

Date Of Birth: 12/19/1991

Level Of Experience: SC

Are You A Veteran?: N

 Driver Application

Disclaimer

DISCLOSURE:

By submitting this application I certify that I personally have completed this application
and that all of the information is true and correct. I hereby authorize C.R. England,
Inc. and its agents or contractors that receive this application to cause to be
conducted, at any time, an investigation of my background for employment purposes,
which may include, but is not limited to, any information relating to my character,
general reputation, personal characteristics, mode of living, criminal history, driving
record, credit history, past work experience, educational background, alcohol or drug
test results, or failure to submit to an alcohol or drug test, or any other information
about me which may reflect upon my potential for employment gathered from any
individual, organization, entity, agency, or other source which may have knowledge
concerning any such items of information. If hired or contracted this authorization for
the above reports shall remain on file and shall serve as ongoing authorization for
C.R. England, Inc to procure consumer reports at any time during my employment or
contract period. I have completed this application of my own free will and hold C.R.
England, Inc., its agents and contractors harmless for all liability for providing this
application for my use. I consent to receiving text (SMS) messages from CR England
and/or its affiliates regarding or relating to my application for employment. I have read
and understand the job description and certify that I am able to meet the
requirements of this position and may be contacted by, which may include, but is not
limited to, email contact, phone contact, direct mail contact.

EMPLOYMENT VERIFICATION:

I hereby authorize C.R. England, Inc to do a complete background investigation,

which includes contacting my past employers regarding my service, character and
drug and alcohol test results as per Federal Motor Vehicle § 391.23 and 382.413.
My past employers are released from any and all liability, which may result from
furnishing such information. I authorize C.R. England to run a consumer report from
USIS (DAC) services. These reports may include information concerning driving
record, work experience, and motor vehicle reports.

DRIVER RIGHTS NOTIFICATION

FMCSA NOTIFICATION OF DRIVER RIGHTS:

In compliance with 49 CFR Part 40 § 391.23 you have certain rights regarding the
performance history information that will be provided to prospective employers. I) You
have the right to review information provided by previous employers. II) You have the
right to have errors in the information corrected by the previous employer and for that
previous employer to re-send the corrected information toprospective employers. III)
You have the right to have a rebuttal statement attached to the alleged erroneous
information, if the previous employer and the driver cannot agree on the accuracy of
the information. 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 prospective employers. This may be
 Driver Application

done at any time, including when applying, or as late as 30 days after being employed
or being notified of denial of employment. Prospective employers mustprovide this
information within five business days of receiving thewritten request. If prospective
employers have not yet received the requested information from the previous
employer, then the five daydeadline will begin when the requested safety
performance history information is received. If you have not arranged to pick up or
receive the requested records within 30 days of prospective employers making them
available. Prospective employers may consider you to have waived your request to
review the record.

Consent to Sign Electronically:

The parties agree that these agreements may be electronically signed. The parties
agree that the electronic signatures appearing on such agreements are the same as
handwritten signatures for the purposes of validity, enforceability and admissibility.

Consent to be contacted:

By providing the information above, I am providing an electronic signature expressly

authorizing C.R. England, its affiliates, or third parties, including, but not limited to,
Top Gear Drivers and GetTruckerJobs.com, to contact me at any address, telephone
number or email address I have provided to communicate with me regarding my
application for employment with C.R. England or other employment opportunities. I
agree that C.R. England, its affiliates, or third parties, including, but not limited to, Top
Gear Drivers and GetTruckerJobs.com, may use SMS (text) messages, automatic
telephone dialing systems or pre-recorded messages in connection with calls made to
any telephone number I entered, even if the telephone number is assigned to a
cellular telephone service or other service for which the called party is charged. I
understand that C.R. England may record telephone conversations I have with its
representatives for quality control and training purposes and I consent to the
recording of those calls. I understand that agreeing to these terms is not a
requirement of applying for a job with C.R. England. I understand that I may apply in
person at any C.R. England terminal.

By entering your name and identifying information above, you are signing this
Disclosure, Consent, and Application electronically. You understand and agree that
your electronic signature is the legal equivalent of your manual signature, pursuant to
the Electronic Signatures in Global and National Commerce Act (E-SIGN) and
applicable state law.

Signature:
 Driver Application

Name: Reinaldo Yen Rodriguez

Timestamp: 2021-01-18 10:44:49 GMT

IP Address: 24.170.12.109