I authorize you to make investigations (including contacting current and prior employers) into my personal, employment, financial, medical history, and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, health care providers, and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all the rules and regulations of the Company. I understand that the information I provide regarding my current and/or prior employers may be used, and those employer(s) will be contacted for the purpose of investigating my safety performance history as required by 49 CFR 391.23.



I understand that I have the right to:

• Review information provided by current/previous employers;

• Have errors in the information corrected by previous employers, and have those previous employers resend the corrected information to the prospective employer; and

• Have a rebuttal statement attached to the alleged erroneous information if the previous employer(s) and I cannot agree on the accuracy of the information.




I authorize AH Trucking, LLC to conduct limited annual queries of the FMCSA’s Drug & Alcohol Clearinghouse, to determine if a Clearinghouse record exists for me. This consent is valid from the date shown below until my employment with the company ceases or until I am no longer subject to drug and Alcohol testing rules in 49 CFR Part 382. I understand that if a query is requested, I must grant electronic consent within 24 hours, via the Clearinghouse website, for the company to obtain the record. Refusal to provide such consent will result in my removal from safety-sensitive duties. This certifies that I completed this application, and that all entries on it and information on it are true and complete to the best of my knowledge. Note: A motor carrier may require an applicant to provide more information than that required by the FMCSA.