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Job Application

Job Application

NAME

XXX-XX-XXXX

CONTACT


CURRENT ADDRESS


PREVIOUS ADDRESS 1


PREVIOUS ADDRESS 2


PREVIOUS ADDRESS 3


xx/xx/xxxx
xx/xx/xxxx
xx/xx/xxxx

EMPLOYMENT HISTORY
All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years.

List complete mailing address, street number, city, state and zip code.

Applicants to drive a commercial motor vehicle* intrastate or interstate commerce shall also provide an additional 7 years' information on those employers for whom the applicant operated such vehicle. (NOTE: List employers in reverse order starting with the most recent. Fax in another sheet as necessary.)


CURRENT / MOST RECENT EMPLOYER

EMPLOYER ADDRESS

PREVIOUS EMPLOYER 1

PREVIOUS EMPLOYER 2

PREVIOUS EMPLOYER 3

PREVIOUS EMPLOYER 4

PREVIOUS EMPLOYER 5


*Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 16 or more passengers (including the driver), or any size vehicle used to transport hazardous materials in a quantity requiring placarding.

†The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weights or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport more than 8 passengers (including the driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

DRIVER EXPERIENCE

*Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 16 or more passengers (including the driver), or any size vehicle used to transport hazardous materials in a quantity requiring placarding.

†The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weights or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport more than 8 passengers (including the driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

*Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 16 or more passengers (including the driver), or any size vehicle used to transport hazardous materials in a quantity requiring placarding.

†The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weights or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport more than 8 passengers (including the driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

*Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 16 or more passengers (including the driver), or any size vehicle used to transport hazardous materials in a quantity requiring placarding.

†The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weights or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport more than 8 passengers (including the driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

*Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 16 or more passengers (including the driver), or any size vehicle used to transport hazardous materials in a quantity requiring placarding.

†The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weights or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport more than 8 passengers (including the driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

*Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 16 or more passengers (including the driver), or any size vehicle used to transport hazardous materials in a quantity requiring placarding.

†The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weights or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport more than 8 passengers (including the driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

Explain other driver experience

DRIVING RECORD AND EXPERIENCE


COMMERCIAL DRIVING


ACCIDENT RECORD


TRAFFIC CONVICTIONS

Traffic Convictions and Forfeitures for the past 3 years (other than parking violations). Fax in another sheet as necessary. If none, write NONE.
CONVICTION 1

CONVICTION 2
CONVICTION 3

DRIVER - OTHER

LICENSES AND PERMITS
List all Driver licenses or permits held over the past 3 years. Fax in another sheet as necessary.



EXPERIENCE WORK

EDUCATION

Select highest grade completed of each (0 if none):

Last school attended:

Section

DISCLOSURE UNDER FAIR CREDIT REPORTING ACT AND
CONSENT TO PROCUREMENT OF CONSUMER REPORT FOR EMPLOYMENT

TO BE READ AND SIGNED BY APPLICANT

THE UNDERSIGNED HEREBY AUTHORIZES ROBERT M. NEFF, INC. TO OBTAIN COPIES OF CONSUMER REPORTS, INCLUDING A MOTOR VEHICLE REPORT, PERTAINING TO ME FOR EMPLOYMENT PURPOSES. I UNDERSTAND THAT IN OBTAINING SUCH CONSUMER REPORTS, A CONSUMER REPORTING AGENCY MAY BE USED, AND I DO HEREBY AUTHORIZE SUCH USE.

I ALSO RELEASE AND HOLD HARMLESS, ANY PERSON, FIRM OR ENTITY THAT DISCLOSES MATTERS IN ACCORDANCE WITH THIS AUTHORIZATION, AS WELL AS ROBERT M. NEFF, INC. FROM LIABILITY THAT MIGHT OTHERWISE RESULT FROM THE REQUEST FOR USE OF AND/OR DISCLOSURE OF ANY OR ALL OF THE FOREGOING INFORMATION. THOSE INQUIRIES MAY BE ORDERED PRE-EMPLOYMENT INITIALLY, PERIODICALLY, OR AS NEEDED BY THE COMPANY FOR EMPLOYMENT AND OVER THE COURSE OF MY EMPLOYMENT.

(TYPE YOUR FULL NAME - THIS CONSTITUTES A DIGITAL SIGNATURE AND WILL BE USED FOR LEGAL PURPOSES.)

CONSENT AND ACKNOWLEDGEMENT

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.


TO BE READ AND SIGNED BY APPLICANT

I authorize Robert M. Neff, Inc. to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) 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 understand, also, that I am required to abide by all rules and regulations of the Company.

I understand that information I provide regarding current and/or previous 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(d) and (e). I understand that I have the right to:

• Review information provided by previous employers;
• Have errors in the information corrected by previous employers and for those previous employers to re-send 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.

(TYPE YOUR FULL NAME - THIS CONSTITUTES A DIGITAL SIGNATURE AND WILL BE USED FOR LEGAL PURPOSES.)

SUMMARY OF RIGHTS

Para informacion en espanol, visite www.ftc.gov/credit o escribe a la FTC Consumer Response Center, Room 130-A 600 Pennsylvania Ave. N.W., Washington, D.C. 20580.

A Summary of Your Rights Under the Fair Credit Reporting Act
The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA.

For more information, including information about additional rights, go to http://www.ftc.gov/credit or write to: Consumer Response Center, Room 130-A, Federal Trade Commission, 600 Pennsylvania Ave. N.W., Washington, D.C. 20580.

You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment – or to take another adverse action against you – must tell you, and must give you the name, address, and phone number of the agency that provided the information.
You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your “file disclosure”). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:
a person has taken adverse action against you because of information in your credit report;
you are the victim of identify theft and place a fraud alert in your file;
your file contains inaccurate information as a result of fraud;
you are on public assistance;
you are unemployed but expect to apply for employment within 60 days. In addition, by September 2005 all consumers will be entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.ftc.gov/credit for additional information.
You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.
You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.ftc.gov/credit for an explanation of dispute procedures.
Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.
Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.
Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need -- usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.
You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.ftc.gov/credit .
You may limit “prescreened” offers of credit a nd insurance you get based on information in your credit report. Unsolicited “prescreened” offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt-out with the nationwide credit bureaus at 1-888-5-OPTOUT (1-888-567-8688).
You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.
Identity theft victims and active duty milit ary personnel have additional rights. For more information, visit www.ftc.gov/credit . States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. Federal enforcers are:
TYPE OF BUSINESS: CONTACT: Consumer reporting agencies, creditors and others not listed below Federal Trade Commission:
Consumer Response Center - FCRA
Washington, DC 20580
1-877-382-4357

National banks, federal branches/agencies of foreign banks (word "National" or initials "N.A." appear in or after bank's name)
Office of the Comptroller of the Currency
Compliance Management, Mail Stop 6-6
Washington, DC 20219
800-613-6743

Federal Reserve System member banks (except national banks, and federal branches/agencies of foreign banks)
Federal Reserve Consumer Help (FRCH)
P O Box 1200
Minneapolis, MN 55480
Telephone: 888-851-1920
Website Address: www.federalreserveconsumerhelp.gov
Email Address: ConsumerHelp@FederalReserve.gov

Savings associations and federally chartered savings banks (word "Federal" or initials "F.S.B." appear in federal institution's name)
Office of Thrift Supervision
Consumer Complaints
Washington, DC 20552
800-842-6929

Federal credit unions (words "Federal Credit Union" appear in institution's name)
National Credit Union Administration
1775 Duke Street
Alexandria, VA 22314
703-519-4600

State-chartered banks that are not members of the Federal Reserve System
Federal Deposit Insurance Corporation Consumer Response Center, 2345 Grand Avenue, Suite 100 Kansas City, Missouri 64108-2638 1-877-275-3342

Air, surface, or rail common carriers regulated by former Civil Aeronautics Board or Interstate Commerce Commission
Department of Transportation , Office of Financial Management
Washington, DC 20590
202-366-1306

Activities subject to the Packers and Sto ckyards Act, 1921 Department of Agriculture


APPLICATION SUBMISSION

If you have completed the ENTIRE application, please click submit below. Incomplete applications WILL be discarded.

WARNING: You CANNOT go back after this point, your application and final answers WILL be submitted.

Robert M. Neff inc.
1955 James Parkway, Heath
Ohio 43056

(800) 356 - 7645 Toll Free
740-928-4393 Local
(740) 928-0770 fax

Dispatch

Full service dispatch utilizes Load Trek software so that they are able to assist our drivers in an extremely efficient manner and can quickly access the status of drivers, trucks and trailers at all times.


Click here to contact Dispatch
Work with us
Robert M. Neff, Inc. is a 3rd generation family owned transportation company. We provide regional and long haul transportation for the US Postal Service. We seek experienced, dependable drivers. Work with us!
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