MOTOR VEHICLE RECORD JURISDICTION SUMMARY oR Complete (As of 2021-10-13705:40:00) FARROW, JEFFREY Case No. 22825547, > PROVIDED BY CLIENT 6109187, FARROW, JEFFREY oR € INFORMATION RETURNED FROM STATE NAME / ADDRESS PHYSICAL IDENTITY “FARROW, JEFFREY HEIGHT WEIGHT EVE HR pos siyt6/1962 LICENSE 6109187 TVPE DETAILS. staus COMMERCIAL CLASS vaup [A-CLASS A COMMERCIAL VEH ANY WEIGHT. MAY TOW ANOTHER VEHICLE > 10K LBS. ENDORSEMENTS DOUBLE TRIPLES(DT) HAZARDOUS MATERIALS(HM) TANK VEHICLE(TY) LcSTATE - oR. ‘ORIGINAL ISSUE - 11/10/1994 vaun PERSONAL CLASS (C-CLASS C NON-COMMERCIAL ANY NON COMMERCIAL VEHICLE RESTRICTIONS: NOTES: UcSTATE- OR, ‘'@ MEDICAL STATUS CERTIFIED STATE-DEFINED. NON-EXCEPTED INTERSTATE Issued 06/23/2021 EXPIRES 06/23/2023 SELE CERTIFICATION: Printed on 1013/2021 064333 94 WWW DRIVERI.COM Dse70 CONFIDENTIAL ssN 2003000 ISSUED EXPIRES Ts2018 11/16/2026 © TAs2018 11/16/2026 rr etyEXAMINER NAME HYUCK KIM © REGISTRATION # LICENSE pc2si0s, SPECIALTY STATE on PHONE STATE DEFINED oc DESCRIPTION REGISTERED WITH THE NATIONAL REGISTRY OF CERTIFIED MEDICAL EXAMINERS HTTPS://WWW.FMCSA.DOT.GOV/NATIONAL-REGISTRY-CERTIFIED-MEDICAL-EKAMINERS-SEARCH © VIOLATIONS VIOLATION DISPOSITION _NOTES DATE DATE osrioy2016 07/21/2016 FAILURE TO PAY APPROPRIATE REG FEE court MARION COUNTY JUSTICE COURT invoiven COMMERCIAL VEHICLE ADDITIONAL MESSAGES DEGREE: VIOLATION DISPOSITION: GUILTY own3por7 02/17/2017, [DRIVE WHILE SUSPENDED/REVOKED V STATE DESCRIPTION DWS/OWRV court coos COUNTY CIRCUIT COURT ADDITIONAL MESSAGES DEGREE: VIOLATION DISPOSITION: GUILTY © OTHER EVENTS TYPE OCCURRED REINSTATEMENT DATE NOTES CANCEL 01/01/2075 ‘TSA CANCEL, ‘ACD CODE THRU DATE START DATE ACTIONTYPE ACTIONCODE CLEAR DATE CANCEL == 0/01/2075 7 ‘cP mec ‘ACD CODE THRU DATE START DATE Printed on 1/13/2021 064333 4 WWW DRIVERIQ.COM Dis CONFIDENTIAL 11/16/2026 11/03/2021 viow cane 1012075 weo 6/24/2021 02/28/2021 2108700870 OTHER (909)285-8656 STATE ACD CODE OR — 50 oR B26 STATE PTS. CODE 303315 ans REPORT NUMBER Ferm ety (case No 22825587TVPE ‘OCCURRED REINSTATEMENT DATE NOTES ACTIONTYPE ACTIONCODE CLEAR DATE CANCEL 07/02/2019. ‘CDPMEDQUAL ‘ACD CODE STATE OFFENSE CODE THRU DATE START DATE ACTIONTYPE ACTIONCODE CLEAR DATE CANCEL 11/03/2016 // INTER HAZ ‘ACD CODE STATE OFFENSE CODE ‘THRU DATE START DATE ACTIONTYPE ACTIONCODE CLEAR DATE SUSPENSION 10/03/2016 01/17/2017 F/COMPLY ‘ACD CODE STATE OFFENSE CODE ‘THRU DATE START DATE court bocker ACTIONTYPE ACTIONCODE CLEAR DATE NOTES TOTAL STATE POINTS :0 CDL Med Status: Medically Certified - Meets Standard PREVIOUS LICENSES: REPORT NUMBER viow cANC 1012075 500 07/02/2019 06/27/2019 viow cane 07/02/2019 03 179 11/03/2016 10/20/2016 viow cane 1103/2016 06 S73 0171372017 10/03/2016 MARION COUNTY JUSTICE COURT 6wo50227 viow susp owtze017 COMMERCIAL CLASS A DRIVER LICENSE ISSUE TYPE: REPLACEMENT ISSUE DATE: 1/17/2017 EXP DATE: 11/16/2018 CANCELLED DATE: 11/18/2018 Printed on 19/13/2021 06433 14 WWW DRIVERIQ.COM Dis CONFIDENTIAL Ferm ety (case No 22825587‘CANCELLED REASON: RENEWED TSA CHECK: RESPONSE: OKAY COMMENCE: 11/3/2016 CEASE: 11/3/2021 “The State of Oregon will only return an MVR if both the name and the drive’ license information matches the original request, therefore the details ofthe report must be associated with the name and license number you provided. The Date of Birth associated with this report was sourced ‘rom the State af Oregon. Al other persona identifies associated with this eeport were not sourced from the State of Oregon, but rather from your initial request. END OF REPORT Printed on 19/13/2021 06433 14 WWW DRIVERIQ.COM Ferm ety pera CONFIDENTIAL (case No 22825587ep . . Background Screening Report «oy Driver iQ Heartland Express 4500 S 129TH EAST AVE SUITE 127. TULSA, OK 74134-5801 Telephone: (877) 867-2359 Fax: (918) 591-2854 CANDIDATE INFORMATION Candidate: FARROW, JEFFREY DOB: 11/16/1962 Social Security Number: 518-54-6593 Date of Request: 10/13/2021 06:40:42 PM Date Completed: 10/19/2021 06:43:28 PM Case Number: 22825547 Type: EBE Ad hoc Candidate's Address: 88986 WHISKEY RUN LN BANDON, OR 97411 UNITED STATES The active research on this applicant has ended. All research elements are complete. REPORT SUMMARY INFORMATION From Date ToDate — Element Type Verification Source Status MOTOR VEHICLE RECORD STATE OF OREGON. Complete Case Comments: Reference 1 Reference 2 Reference 3: radams OrderlD: 336744 ContextID: Heartland Biatus Definitions ‘Adverse “The report component is complete and includes discrepant or negative information, Clear Clear, no review required. Complete ‘Compete and ready for review. Error ‘The report component could not be completed due to incorrect input of information, Needs Review _ | The report is complete, however, the component contains information that should be reviewed. NotPursued | Lead intentionally closed before research completed. Pending Lead stil being researched, See Detail Rosulis are neither clear nor adverse for this component. Refer to “Invesiigalive Detail" pages for more information. ‘FF END OF REPORT *** neg TORE OSS Pod Waw oANERIG COW FARROW, JEFFREY DisP70 CONFIDENTIAL ‘case No. 20825547 Page 1