To Be Read and Signed by Applicant
It is agreed and understood that any misrepresentation given on this application shall be considered an act of dishonesty.
It is agreed and understood that the motor carrier or his agents may investigate the applicant's background to ascertain any and all information of concern to applicant's record, whether same is of record or not, and applicant releases employers and persons named herein from all liability for any damages on account of his furnishing such information.
It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an investigating Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living.
I agree to furnish such additional information and complete such examinations as may be required to complete my application file.
It is agreed and understood that this Application for Qualification in no way obligates the motor carrier to employ or hire the applicant.
It is agreed and understood that if qualified and hired, I may be on a probationary period during which time I may be disqualified without recourse. This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.
I understand that the information in this application will be used and that prior employers will be contacted for the purposes of investigation as required by 391.23 of the Federal Motor Carrier Safety Regulations.
I certify that the above information is correct and given of my own free will and accord. I also certify that I have not knowingly withheld any information which will reflect upon my fitness as a candidate for the position of which I am applying. I understand that giving false information or withholding pertinent information can disqualify me for this position. I also understand that if I am employed and I am found to have given false information this will serve as cause for my removal from the job at any time it might be revealed that false information was given. In consideration of my employment, I agree to conform to the rules of this Company and the Federal Motor Carrier Safety Regulations and any other relevant Regulations and Laws. I hereby acknowledge that my employment with the company can be terminated at any time, with or without cause, at the option of either myself or the Company. I further understand and acknowledge that nothing contained in any employee handbook or policy statement received by me at the commencement of my employment if hired, nullifies or modifies the foregoing.