Employment

Employment Record
DOT requires that all applicants wishing to drive a commercial motor vehicle must provide the following information on all previous employers during the proceeding three (3) years. You must give the same information for whom you have driven a commercial motor vehicle for an additional seven (7) years. You are required to list the complete address: Street number and name, city, state, and zip code. Any gaps in employment and/or unemployment must be explained.
Current/Last Employer
Employer's Name*
Employer's Phone Number*
Position You Held*
Started*
Ended
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reason for Leaving*
Were you subject to the Federal Motor Carriers Safety Regulations (FMCSRs)?*
- Yes
- No
Was your job designated as a safety-sensitive function in any DOT-regulated mode, subject to the drug and alcohol testing requirements of 49 CFR Part 40?*
- Yes
- No
Account for time between jobs (month/year) and reason.*
Second Last Employer
Employer's Name*
Employer's Phone Number*
Position You Held*
Started*
Ended
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reason for Leaving*
Were you subject to the Federal Motor Carriers Safety Regulations (FMCSRs)?*
- Yes
- No
Was your job designated as a safety-sensitive function in any DOT-regulated mode, subject to the drug and alcohol testing requirements of 49 CFR Part 40?*
- Yes
- No
Account for time between jobs (month/year) and reason.*
Third Last Employer

Step 1 of 3

Applicant Information

Employment Record

Current/Last Employer

Second Last Employer

Third Last Employer

Experience & Qualifications