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19 Employee Driving Record

The document is an Employee Driving Record form for ABC Contractors, requiring the employee to provide personal information and answer questions regarding their driving history. It includes inquiries about license suspensions, DUI citations, moving violations, and accidents within the past three years. The employee must also consent to a verification of their driving record and certify the accuracy of their responses.

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k12educationwise
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70 views1 page

19 Employee Driving Record

The document is an Employee Driving Record form for ABC Contractors, requiring the employee to provide personal information and answer questions regarding their driving history. It includes inquiries about license suspensions, DUI citations, moving violations, and accidents within the past three years. The employee must also consent to a verification of their driving record and certify the accuracy of their responses.

Uploaded by

k12educationwise
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Employee Driving Record

ABC CONTRACTORS
123 Any Street
Anytown, US 00000
555-555-5555

Date: Phone:

Employee: Driver’s Lic. No.:

Address: State:

Please answer the following questions:


1. Has your license ever been suspended or revoked? Yes No
If yes, please explain:

2. Have you ever been cited for driving under the influence? Yes No
If yes, please explain:

3. Have you received any moving violations within the past 3 years? Yes No
If yes, please explain:

4. Have you been involved in any accidents within the past 3 years? Yes No
If yes, please explain:

I give my permission for you to obtain a verification of my driving record.


I certify that the above information is true and correct.

Signed: Date:

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