It is agreed and understood that any misrepresentation of information given shall be
considered an act of dishonesty. It is agreed and understood that the carrier or its
agents may investigate the applicant's background to ascertain any and all information
of concern to the applicant's record, whether same is of record or not, and applicant
releases carrier 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 investigative 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 for qualification file. (PENNSYLVANIA RESIDENTS ONLY) I
authorize the carrier to obtain from the Registry of Motor Vehicles a copy of my motor
vehicle violations record. It is agreed and understood that this application for
qualification under the DOT Regulations in no way obligated the carrier to qualify me,
and it is understood that if qualified, I may be on a introductory period during which
time I may be released without recourse. I agree and authorize previous employers to
release and forward all information on my alcohol and controlled substance testing.
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.
