Intelliapp (Com) : Swift Transportation Co. of Arizona LLC

Swift Transportation Co.
of Arizona LLC 03-24-2020 1:03:51PM CDT

2200 South 75th Avenue
Phoenix, AZ 85043
866-437-3050
IntelliApp (Com)
Thank you for your interest in Swift Transportation Co. of Arizona, LLC. To apply for a
driving position, please complete our online application for employment. Incomplete
information will delay the processing of your application or prevent it from being
submitted.
In compliance with Federal and State equal employment opportunity laws, qualified
applicants are considered for all positions without regard to race, color, religion, sex,
national origin, age, marital status, veteran status, non-job related disability, or any other
protected group status.
Personal Information
Referral Code: AutoResp
Name Melaku Tewolde Haleka
Residence 3 years or longer (If No, No
previous addresses shown below)
Current Address 7057 Pinebrook Ctctct Las Vegas Nv
Address 2 7057 Pinebrook Ct Las Vegas Nv
City, State/Province Zip/Postal Las Vegas, NV 89147
Country United States
Addresses Over last 3 years Address 1
7057 Pinebrook ctctCt Las Vegas Nv
Las Vegas, NV 89147
United States
10-2016 to 10-2020
SSN/SIN ###-##-8373
Date of Birth ##-##-####
Primary Phone 702-854-8343
Cell Phone 702-854-8343
Preferred method of contact Primary Phone
Best time to contact you Any
Email melakutewelde60@gmail.com
Yes, I want to receive information and Yes
communications from Swift Transportation
Co. of Arizona LLC concerning future
opportunities or promotions.
Yes
1
Would you like to receive communication
from Swift Transportation via text
message?
Company Questions
Comments:
Please Explain
GENERAL INFORMATION
If you have spoken to a recruiter, please Cyndi Kik
select their name:
How did you hear about us? Internet
If you selected Referral, CDL School, google
Internet, or Other above, please provide
details to further clarify:
What is your Class A Driving Experience Have Class A CDL, But Need Training
Level?
Would you like to run as a team? Yes
What type of equipment do you prefer to Dry Van
drive?
Are you interested in being a Student Yes
Driver Mentor?
What date will you be available to start? 03-24-2020
If hired, can you present evidence of your Yes
U.S. Citizenship or proof of your legal right
to live and work in this country?
Do you read, write, and speak English? Yes
Have you ever worked for this company No
before?
Enter start and end dates, location,
position, and reason for leaving:
Do you have a current TWIC card? No
Expiration date:
Do you have experience with Qualcom No
operations?
Please enter the names of any relatives no
employed here:
Have you ever used any illegal drug No
(including marijuana)?
When was the last time?
Comments:
2
Have you ever tested positive, or refused No
to test on a pre-employment drug or
alcohol test by an employer to whom you
applied in the past ten years, or have you
ever tested positive or refused to test on
any mandated drug or alcohol test?
Please Explain
Have you ever been known by any other No
name?
Enter name:
Name: genet mekonen
Address: 7057 pinebrook ct las vegas
City: las vegas
State: nv
Zip: 89147
Relationship: wife
Phone Number: 7024017613
Do you have any trailer hauling No
experience?
Flatbed
Van
Tanker
Reefer
Hazmat
Dropdeck
Do you have any trailer preferences? No
Flatbed
Van
Tanker
Reefer
Hazmat
Dropdeck
EDUCATION
List highest grade completed: Grade 12
Did you graduate from college? Yes
PERSONAL REFERENCES
Name: genet mekonen
3
Relationship: wife
Name: genet mekonen
Relationship: wife
Number of DUIs
Number of moving violations in the past 2
years
Number of accidents in the past 2 years
Google EF Tracking
Truck School
Field Recruiter
Academy Coordinator
Worklist
Licenses
License Number #########086
State/Province NV
License Class Class A
Original Issue Date 02-25-2020
License Expiration Date 01-10-2028
Physical Expiration Date 01-10-2022
Current License Yes
Commercial Driver License Yes
Endorsements
Tanker Endorsement No
HAZMAT Endorsement No
X Endorsement No
Doubles Triples Endorsement No
Other Endorsement No
4
Employment / Unemployment
Green Valley Grocery
Company Green Valley Grocery
Contact / Supervisor Name ronda
Start Date 08-2017
End Date 03-2020
Address 300 e warm spring rd las vegas
Address 2 300 e warm spring rd las vegas
City, State/Province Zip/Postal Las Vegas, NV 89119
Phone 702-932-4850
Position Held cashier
Reason for leaving? for better opportunity
Were you terminated/discharged/laid off? No
Is this your current employer? Yes
May we contact this employer at this time? Yes
Did you operate a commercial motor No

vehicle?
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Did you perform any safety sensitive
functions in this job subject to drug and
alcohol testing?
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Trailer length
meskel flower market
Company meskel flower market
Contact / Supervisor Name mahlet
Start Date 03-2000
End Date 07-2017
5
Address 340 denbel
City, State/Province Zip/Postal Addis Ababa, SHEWA 6727
Country Ethiopia
Phone 091-160-9786
Position Held manger
Reason for leaving? moving to usa
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor No

vehicle?
Were you subject to the Federal Motor
Regulations while employed/contracted by
this employer/contractor?
Did you perform any safety sensitive
functions in this job subject to drug and
alcohol testing?
Areas Driven
Miles driven weekly
Pay Range (cents/mile)
Most common truck driven
Most common trailer
Trailer length
Trucking School
Start Date 02-2020
End Date 03-2020
School RTDS trucking school
City, State/Province Las Vegas Nv, NV
Phone 702-527-2314
Did you graduate? Yes
Were you subject to the Federal Motor Yes
Regulations while attending this truck
school?
6
Did you perform any safety sensitive Yes
functions at this truck school, regulated by
DOT, and subject to drug and alcohol
testing?
GPA 83%
Hours of Instruction 60
Border Crossing Yes
Log Books Yes
Federal Motor Carrier Regulations Yes
Hazardous Materials Yes
FMCSR
Under FMCSR 391.15, are you currently No
disqualified from driving a commercial
motor vehicle? [49 CFR 391.15]
Has your license, permit or privilege to No
drive ever been suspended or revoked for
any reason? [49 CFR 391.21(b)(9)]
Have you ever been denied a license, No
permit, or privilege to operate a motor
vehicle?[49 CFR 391.21(b)(9)]
Within the past two years, have you tested No
positive, or refused to test, on a
pre-employment drug or alcohol test by an
employer to whom you applied, but did not
obtain, safety-sensitive transportation work
covered by DOT agency drug and alcohol
testing rules? [49 CFR 40.25(j)]
In the past three(3) years, have you ever No
been convicted of any of the following
offenses: [49 CFR 391.15]:
• Driving a commercial motor vehicle

with a blood alcohol concentration
("BAC") of .04 percent or more
• Driving under the influence of
alcohol, as prescribed by state law
• Refusal to undergo drug and
alcohol testing as required by any
jurisdiction for the enforcement of
Federal Motor Carrier Safety Act
regulations
• Driving a commercial motor vehicle
under the influence of any 21
C.F.R. 1308.11 Schedule I
identified controlled substance, an
7
amphetamine, a narcotic drug, a
formulation of an amphetamine, or
a derivative of a narcotic drug
• Transportation, possession, or
unlawful use of a 21 C.F.R.
1308.11 Schedule I identified
controlled substance,
amphetamines, narcotic drugs,
formulations of an amphetamine, or
derivatives of narcotic drugs while
you were on duty driving for a
motor carrier
• Leaving the scene of an accident
while operating a commercial motor
vehicle
• Or any other felony involving the
use of a commercial motor vehicle
Vehicle Accident Record

Were you involved in any accidents/incidents with any vehicle in the last 5 years (even
if not at fault)?
No Accidents
Traffic Convictions \ Violations

Have you had any moving violations or traffic convictions in the past 5 years?
No Violations
Criminal Record
All Applicants: Do not disclose information regarding arrests, charges, and/or
convictions that have been sealed, expunged, annulled, erased, statutorily eradicated,
or judicially dismissed. Answering yes to any of the questions below will not
automatically disqualify you from employment and instead will be considered, on an
individualized basis, only as it relates to the job in question.
California Applicants: In California, "crime" shall exclude convictions for

marijuana-related offenses that are more than two years old, as defined in California
Health and Safety Code sections 11357 (b) and (c) and 11360 (c), or in California
Health and Safety Code sections 11364, 11365, or 11550 of the Health and Safety
Code as they related to marijuana prior to January 1, 1976, or their statuary
predecessors.
Washington Applicants: Do not disclose information regarding convictions that

occurred more than ten years ago or for which you were released from prison more
than ten years ago.
No
8
Have you ever been convicted of a
criminal offense?
Please explain. Be sure to include
specifics about whether it was a felony or a
misdemeanor, the nature of the crime, the
state of the conviction, the date of
conviction, the fine or sentence imposed,
and whether the sentence has been
completed, and if so when.
Do you currently have any criminal actions No
pending in which you are a defendant?
Please explain. Be sure to include
specifics about whether it is a felony or a
misdemeanor, the nature of the alleged
crime, the state the action is pending in,
and if applicable, any scheduled trial date
or other date by which the matter will be
resolved.
Signature
Full Name Melaku Tewolde Haleka
IP Address 70.189.255.192
Signature Date/Time 03-24-2020 1:03 PM
By signing my application below, I agree to use an electronic signature to demonstrate
my consent. An electronic signature is as legally binding as an ink signature.
This certifies that this application was completed by me, and that all entries on it and
information on it are true and complete to the best of my knowledge.
Signed Date: 03-24-2020 1:03 PM
Signed:
Federal FCRA Summary of Rights Acknowledgment

By checking this box, I acknowledge that I Yes
have received and reviewed the attached
FCRA Statement of Rights.
Notice to Applicants of Rights Under Section 615(a)(3).

Yes
9
NOTICE TO APPLICANTS OF RIGHTS
UNDER Sec. 615(a)(3) OF THE FAIR
CREDIT
REPORTING ACT (15 U.S.C. Sec.

1681m)
To the extent you applied for a driving

position with Swift Transportation by mail,
telephone, facsimile, e-mail, computer, via
the internet, or other similar means, you
are hereby provided with notice of the
following:
(A) The name, address and

toll-free telephone number
of the consumer reporting
agencies that furnished
Swift with the report. Those
consumer reporting
agencies are:
(Provides
Verifynd and
all Criminal
Reports)
Asurint
P.O. Box
14730
Cleveland,
OH 44145
(800)
906-2034
www.asurint.com/Compliance.aspx
compliance@asurint.com
(Provides
MVR, CDLIS
and PRE
Report)
Tenstreet
120 W. 3rd
Street
Tulsa, OK
74103
877-219-9283
(Provides
PRE Report)
CARCO/Driver
iQ
1070
Lillington
Highway
10
Spring Lake,
NC 28390
Toll Free
1-855-881-0716
disputes@carcogroup.com
www.carcogroup.com
(B) To the extent that any

adverse action might be
taken based in whole or in
part on any consumer
report, the above listed
consumer reporting
agencies did not or will not
make the decision to take
the adverse action and
cannot or will not be able to
provide you with the specific
reasons why the adverse
action was or will be taken.
(C) Your right to obtain,

under section 612 [Sec.
1681j], a free copy of your
consumer report from the
consumer reporting agency
identified above, not later
than 60 days from receipt of
this notice and/or any notice
of an adverse action.
(D) Your right to dispute,

under section 611 [Sec.
1681i], with the consumer
reporting agencies the
accuracy or completeness
of any information in a
consumer report furnished
by the agency.
PSP Disclosure and Authorization

By checking the box, I (a) acknowledge Yes
that I have read and understand the PSP
Disclosure and Authorization and also
have been given the opportunity to
copy/print it, and (b) agree to use an
electronic signature to demonstrate my
consent. An electronic signature is as
legally binding as an ink signature.
11
FCRA Disclosure and Authorization to Conduct Background Investigation
By my check of this box, I represent that I Yes
understand and agree to the above FCRA
Disclosure and Authorization to Conduct
Background Investigation and that I intend
to execute this document by electronic
signature in checking this box.
Employment Verification Acknowledgment and Release (DOT Drug and Alcohol)

that I have read and understand the above
and also have been given the opportunity
to copy/print it, and (b) agree to use an
Clearinghouse Release
that I have read and understand the above
and also have been given the opportunity
to copy/print it, and (b) agree to use an
User Requested Copy

User requested a copy to be sent to this Yes
email address
melakutewelde60@gmail.com.
12
BACKGROUND INFORMATION DISCLOSURE AND CONSENT
In connection with your employment or application for employment (including contract for services) through Swift Transportation Co. of Arizona, LLC,
Knight-Swift Transportation Holdings and all subsidiaries and related entities, consumer reports (Investigative Consumer Reports in California) may be
requested from Driver IQ and/or Asurint (collectively "Third Party Providers"). These reports may include the following types of information: names and
dates of previous employers, reasons for termination of employment, work experience, accidents, academic history, professional credentials and
drug/alcohol use. Such reports may contain public record information concerning your driving record, workers' compensation claims, credit, bankruptcy
proceedings, criminal records, etc. from federal, state and other agencies that maintain such records; as well as information from Third Party Providers
concerning previous driving record requests made by others from such state agencies and state provided driving records.
We also will obtain driving/accident and safety inspection history records maintained by the Federal Motor Carrier Safety Administration ("FMCSA").
You have the right to make a request to all potential third parties, upon proper identification, to request the nature and substance of all information in its
files on you at the time of your request, including the explaining of any coded information, the sources of information and the recipients of any reports
on you that Third Party Providers have previously furnished within the past two year period preceding your request (3 years in California). Driver IQ
may be contacted by mail at 4500 South 129th East Ave, Suite 127, Tulsa, OK 74134 or by telephone at 800-832-5184. Asurint may be contacted by
mail at P.O. Box 14730, Cleveland, OH 44114 or by telephone at 800-906-1674. Information about Driver IQ's privacy practice is available at
http://www.carcogroup.com/privacy-policy.php.
I AUTHORIZE, WITHOUT RESERVATION, THIRD PARTY PROVIDERS, FMCSA AND ANY OTHER PARTY OR AGENCY CONTACTED BY
DRIVER IQ AND/OR ASURINT TO FURNISH THE ABOVE MENTIONED INFORMATION. THIS AUTHORIZATION DOES NOT APPLY TO DRUG
AND ALCOHOL INFORMATION CONTAINED UNDER PART I.
I hereby consent to your obtaining the above information from Third Party Providers, and I agree that such information which Third Party Providers
have or obtain in my employment history (not DOT drug and alcohol information without a specific consent by me) with you if I am hired, will be
supplied by Third Party Providers to other companies which subscribe to Third Party Providers. I hereby authorize procurement of consumer reports as
set forth above.
If hired or contracted, this authorization for reports covered by this release only shall remain on file and shall serve as an ongoing authorization for you
to procure consumer reports at any time during my employment or contract period.
I consent to you obtaining the above information from FMCSA. I understand that the FMCSA maintains sole control over that data and you cannot
change or alter such information. If I dispute any information maintained by FMCSA, I must personally contact the FMCSA by accessing the DataQs
System at: https://dataqs.fmcsa.dot.gov.
Printed Name: Melaku Tewolde Haleka

Melaku Tewolde Haleka 7057 Pinebrook Ctctct Las Vegas
Nv
Social Security #: 7057 Pinebrook Ct Las Vegas Nv
###-##-8373 Las Vegas, NV 89147
Signed Date: 03-24-2020 702-854-8343
Gender:
13
IMPORTANT DISCLOSURE
REGARDING BACKGROUND REPORTS FROM THE PSP Online Service
In connection with your application for employment with Swift Transportation Co. of Arizona 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 Swift Transportation Co. of Arizona 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.
Printed Name:
Melaku Tewolde Haleka
Signed Date: 03-24-2020
14
General Consent for Limited Queries of the FMCSA Drug and Alcohol Clearinghouse
Knight-Swift Transportation Holdings, Inc.
I hereby provide consent to Knight-Swift Transportation Holdings, Inc., and its agents, subsidiaries, and assigns,
including, but not limited to Swift Transportation Co. of Arizona, LLC, Kold Trans, Barr-Nunn Transportation Inc.,
Abilene Motor Express Inc., and Knight Transportation, Inc., (the "Company"), along with its Third-Party
Administrators ("TPAs"), DriverFacts and Tenstreet, on the behalf of Company, to conduct a limited query of the
FMCSA Commercial Driver's License Drug and Alcohol Clearinghouse (Clearinghouse) to determine whether drug
and/or alcohol violation information exists about me in the Clearinghouse.
I understand and acknowledge that this consent is valid for both pre-employment limited inquiries, and if selected for
hire, will remain in effect for the duration of my employment with the Company. I understand this consent is for multiple
limited inquiries during the duration of my employment with the Company. I further understand that if I fail to sign
below, the Company will prohibit me from performing safety-sensitive functions, including driving a commercial motor
vehicle.
I also understand that, as part of the pre-employment process, a full query will be run before I am allowed to perform
safety sensitive activities for the Company. Full queries require me to provide consent to the FMCSA Clearinghouse and
that I may register with the FMCSA Clearinghouse at clearinghouse.fmcsa.dot.gov.
I understand that if a limited query indicates that data exists in the Clearinghouse about me, a Full query will be
requested. I will need to authorize release of data via the FMCSA Clearinghouse website within 24 hours. My failure to
authorize release of data via the FMCSA Clearinghouse will prohibit me from performing safety-sensitive functions with
and/or for the Company.
I further understand that if I refuse to provide consent for Company or its TPAs to conduct a limited or full query of the
Clearinghouse, the Company must prohibit me from performing safety-sensitive functions, including driving a
commercial motor vehicle, as required by FMCSA's drug and alcohol program regulations.
03-24-2020
Melaku Tewolde Haleka Date
15
Request/Consent for Information from Previous Employer(s)/Carrier(s) For Alcohol and Controlled Substances Testing
Records
And changes in Parts 390 and 391 of the FMCSA
X 03-24-2020 X ###-##-8373 Melaku Tewolde Haleka

7057 Pinebrook Ctctct Las Vegas
Date Social Security Number
Nv
7057 Pinebrook Ct Las Vegas Nv
Las Vegas, NV 89147
702-854-8343
X Melaku Tewolde Haleka X Gender:
Print Name (First, MI, Last) Signature
I, the above mentioned signer, hereby authorize RTDS trucking school
To release and forward in accordance with the following regulation, all known information pertaining to my alcohol and controlled substances
testing/training records to Swift Transportation Co. of Arizona LLC
EMPLOYMENT VERIFICATION ACKNOWLEDGEMENT AND RELEASE
I hereby authorize you, as a former employer identified by me, to release information to Swift Transportation Co. of
Arizona, LLC, Knight-Swift Transportation Holdings and all subsidiaries and related entities for the purpose of
investigation as required by Section 391.23 and allowed by Section 383.35 of the Federal Motor Carrier Safety
Administration regulations. This information includes (where applicable): 1) Dates of employment; 2) Position(s) held;
3) Driver type (including whether I was subject to the Federal Motor Carrier Safety Administration regulations and
Department of Transportation drug and alcohol testing); 4) Equipment used; 5) Area driven; 6) Whether I was
terminated; 7) Whether I am eligible for rehire; 8) Accident information (including accident date, nature of accident,
whether it was preventable, whether it was Department of Transportation reportable, whether there were any injuries or
fatalities, and whether it involved any hazardous materials); and 9) Drug and Alcohol testing information (including
whether I had any alcohol tests with a result of .04 or higher, any verified positive drug tests, whether I refused to be
tested, and whether I had any other violations of Department of Transportation drug and alcohol testing regulations). 10)
Any non-DOT drug testing information where I have tested positive I hereby expressly release you from any and all
liability that may result from furnishing such information to Swift Transportation Co. of Arizona, LLC, Knight-Swift
Transportation Holdings and all subsidiaries and related entities.
I understand and acknowledge that pursuant to Section 391.23(i)(1) of the Federal Motor Carrier Safety Administration
regulations, I have a right to review information provided by previous employers, a right to have errors in the
information corrected by previous employers and resent to Swift Transportation Co. of Arizona, LLC, Knight-Swift
Transportation Holdings and all subsidiaries and related entities with the corrected information, and the right to have a
rebuttal statement attached to any alleged erroneous information, if the previous employer and I cannot agree on the
accuracy of the information.
16
set forth above.
Employer / Contractor / Educational Institution: Melaku Tewolde Haleka

Green Valley Grocery 7057 Pinebrook Ctctct Las
Vegas Nv
Printed Name: 7057 Pinebrook Ct Las
Melaku Tewolde Haleka Vegas Nv
Las Vegas, NV 89147
Social Security #: 702-854-8343
###-##-8373 Gender:
17
set forth above.
Employer / Contractor / Educational Institution: Melaku Tewolde Haleka

meskel flower market 7057 Pinebrook Ctctct Las
Vegas Nv
Printed Name: 7057 Pinebrook Ct Las
Melaku Tewolde Haleka Vegas Nv
Las Vegas, NV 89147
Social Security #: 702-854-8343
###-##-8373 Gender:
18
A Summary of Your Rights Under the Fair Credit Reporting Act
Para informacion en espanol, visite www.consumerfinance.gov/learnmore o escribe a la Consumer Financial Protection
Bureau, 1700 G Street N.W., Washington, DC 20552.
A Summary of Your Rights Under the Fair Credit Reporting Act
The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of
consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and
specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental
history records). Here is a summary of your major rights under the FCRA. For more information, including
information about additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial
Protection Bureau, 1700 G Street N.W., Washington, DC 20552.
• You must be told if information in your file has been used against you. Anyone who uses a credit report or another type
of consumer report to deny your application for credit, insurance, or employment - or to take another adverse action against
you - must tell you, and must give you the name, address, and phone number of the agency that provided the information.
• You have the right to know what is in your file. You may request and obtain all the information about you in the files of a
consumer reporting agency (your "file disclosure"). You will be required to provide proper identification, which may include
your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:
♦ a person has taken adverse action against you because of information in your credit report;
♦ you are the victim of identity theft and place a fraud alert in your file;
♦ your file contains inaccurate information as a result of fraud;
♦ you are on public assistance;
♦ you are unemployed but expect to apply for employment within 60 days.
In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit
bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for additional
information.
• You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on
information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or
distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you
will receive credit score information for free from the mortgage lender.
• You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is
incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is
frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.
• Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate,
incomplete, or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting
agency may continue to report information it has verified as accurate.
• Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting
agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years
old.
• Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid
need - usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies
those with a valid need for access.
• You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out
information about you to your employer, or a potential employer, without your written consent given to the employer. Written
consent generally is not required in the trucking industry. For more information, go to www.consumerfinance.gov/learnmore.
• You may limit "prescreened" offers of credit and insurance you get based on information in your credit report.
Unsolicited "prescreened" offers for credit and insurance must include a toll-free phone number you can call if you choose to
remove your name and address form the lists these offers are based on. You may opt out with the nationwide credit bureaus
at 1-888-5-OPTOUT (1-888-567-8688).
19
• The following FCRA right applies with respect to nationwide consumer reporting agencies:
CONSUMERS HAVE THE RIGHT TO OBTAIN A SECURITY FREEZE
You have a right to place a "security freeze" on your credit report, which will prohibit a consumer reporting agency
from releasing information in your credit report without your express authorization. The security freeze is designed to
prevent credit, loans, and services from being approved in your name without your consent. However, you should be aware
that using a security freeze to take control over who gets access to the personal and financial information in your credit report
may delay, interfere with, or prohibit the timely approval of any subsequent request or application you make regarding a new
loan, credit, mortgage, or any other account involving the extension of credit.
As an alternative to a security freeze, you have the right to place an initial or extended fraud alert on your credit file at no
cost. An initial fraud alert is a 1-year alert that is placed on a consumer's credit file. Upon seeing a fraud alert display on a
consumer's credit file, a business is required to take steps to verify the consumer's identity before extending new credit. If you
are a victim of identity theft, you are entitled to an extended fraud alert, which is a fraud alert lasting 7 years.
A security freeze does not apply to a person or entity, or its affiliates, or collection agencies acting on behalf of the person or
entity, with which you have an existing account that requests information in your credit report for the purposes of reviewing or
collecting the account. Reviewing the account includes activities related to account maintenance, monitoring, credit line
increases, and account upgrades and enhancements.
• You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or
a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.
• Identity theft victims and active duty military personnel have additional rights. For more information, visit
www.consumerfinance.gov/learnmore.
20
States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may
have more rights under state law. For more information, contact your state or local consumer protection agency
or your state Attorney General. For information about your federal rights, contact:
TYPE OF BUSINESS: CONTACT:
1.a. Banks, savings associations, and credit unions with total a. Consumer Financial Protection Bureau
assets of over $10 billion and their affiliates 1700 G Street, N.W.
Washington, DC 20552
b. Such affiliates that are not banks, savings associations, or
credit unions also should list, in addition to the CFPB: b. Federal Trade Commission
Consumer Response Center
600 Pennsylvania Avenue, N.W.
(877) 382-4357
2. To the extent not included in item 1 above: a. Office of the Comptroller of the Currency
a. National banks, federal savings associations, and federal Customer Assistance Group
branches and federal agencies of foreign banks 1301 McKinney Street, Suite 3450
b. State member banks, branches and agencies of foreign banks Houston, TX 77010-9050
(other than federal branches, federal agencies, and Insured
State Branches of Foreign Banks), commercial lending b. Federal Reserve Consumer Help Center
companies owned or controlled by foreign banks, and P.O. Box 1200
organizations operating under section 25 or 25A of the Federal Minneapolis, MN 55480
Reserve Act.
c. Nonmember Insured Banks, Insured State Branches of c. FDIC Consumer Response Center
Foreign Banks, and insured state savings associations 1100 Walnut Street, Box #11
d. Federal Credit Unions Kansas City, MO 64106
d. National Credit Union Administration

Office of Consumer Financial Protection (OCFP)
Division of Consumer Compliance Policy and Outreach
1775 Duke Street
Alexandria, VA 22314
3. Air Carriers Asst. General Counsel for Aviation Enforcement & Proceedings
Aviation Consumer Protection Division
Department of Transportation
1200 New Jersey Avenue, S.E.
4. Creditors Subject to the Surface Transportation Board Office of Proceedings, Surface Transportation Board
Department of Transportation
395 E Street, S.W.
5. Creditors Subject to the Packers and Stockyards Act, 1921 Nearest Packers and Stockyards Administration area supervisor
6. Small Business Investment Companies Associate Deputy Administrator for Capital Access
United States Small Business Administration
409 Third Street, S.W., Suite 8200
7. Brokers and Dealers Securities and Exchange Commission

100 F Street, N.E.
8. Federal Land Banks, Federal Land Bank Associations, Farm Credit Administration
Federal Intermediate Credit Banks, and Production Credit 1501 Farm Credit Drive
Associations McLean, VA 22102-5090
9. Retailers, Finance Companies, and All Other Creditors Not Federal Trade Commission
Listed Above Consumer Response Center
600 Pennsylvania Avenue, N.W.
(877) 382-4357
21

Intelliapp (Com) : Swift Transportation Co. of Arizona LLC

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Swift Transportation Co.

of Arizona LLC 03-24-2020 1:03:51PM CDT

Did you operate a commercial motor No

Did you operate a commercial motor No

• Driving a commercial motor vehicle

Vehicle Accident Record

Traffic Convictions \ Violations

California Applicants: In California, "crime" shall exclude convictions for

Washington Applicants: Do not disclose information regarding convictions that

Signed Date: 03-24-2020 1:03 PM

Federal FCRA Summary of Rights Acknowledgment

Notice to Applicants of Rights Under Section 615(a)(3).

REPORTING ACT (15 U.S.C. Sec.

To the extent you applied for a driving

(A) The name, address and

(B) To the extent that any

(C) Your right to obtain,

(D) Your right to dispute,

PSP Disclosure and Authorization

Employment Verification Acknowledgment and Release (DOT Drug and Alcohol)

User Requested Copy

Printed Name: Melaku Tewolde Haleka

Knight-Swift Transportation Holdings, Inc.

X 03-24-2020 X ###-##-8373 Melaku Tewolde Haleka

EMPLOYMENT VERIFICATION ACKNOWLEDGEMENT AND RELEASE

Employer / Contractor / Educational Institution: Melaku Tewolde Haleka

Employer / Contractor / Educational Institution: Melaku Tewolde Haleka

A Summary of Your Rights Under the Fair Credit Reporting Act

CONSUMERS HAVE THE RIGHT TO OBTAIN A SECURITY FREEZE

TYPE OF BUSINESS: CONTACT:

d. National Credit Union Administration

7. Brokers and Dealers Securities and Exchange Commission

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