Please read our pre-employment consent agreement and use the eSign button at the bottom to complete the agreement.
PRE-EMPLOYMENT URINALYSIS CONSENT AGREEMENT
In connection with your application for employment with Prewitt and Son Trucking Company, Prewitt and Son Trucking Company, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection history
from the Federal Motor Carrier Safety Administration (FMCSA).
When the application for employment is submitted in person, if Prewitt and Son Trucking Company uses any information it obtains from FMCSA in a decision not to hire you or make any adverse employment decision regarding you, Prewitt and Son Trucking Company will provide you with a copy of the report which the decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you your driving history or safety report, Prewitt and Son Trucking Company will notify you that the action has been taken and that the action was based in part or in whole on this report.
When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prewitt and Son Trucking Company uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding. you, Prewitt and Son Trucking Company must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision or take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, Prewitt and Son Trucking Company must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act.
Neither Prewitt and Son Trucking Company nor FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to: https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication.
Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported ot FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report.
Prewitt and Son Trucking Company cannot obtain background reports from FMCSA without your authorization.
AUTHORIZATION
If you agree that Prewitt and Son Trucking Company may obtain such background reports, please read the following and submit your agreement below:
I authorize Prewitt and Son Trucking Company to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information including crash data from the previous 5 years and inspection history from the previous 3 years. I understand and acknowledge that this release of information may assist Prewitt and Son Trucking Company to make a determination regarding my suitability as an employee.
I further understand that neither Prewitt and Son Trucking Company nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to: https://dataqs.fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand request will be forwarded by the DataQs system to the appropriate State for adjudication.
I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include al CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand al inspections, with or without violations, will appear no my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report.
I have read the above Disclosure Regarding Background Reports provided to me by Prewitt and Son Trucking Company and I understand that if I agree to this Disclosure and Authorization, Prewitt and Son Trucking Company may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above.
from the Federal Motor Carrier Safety Administration (FMCSA).
When the application for employment is submitted in person, if Prewitt and Son Trucking Company uses any information it obtains from FMCSA in a decision not to hire you or make any adverse employment decision regarding you, Prewitt and Son Trucking Company will provide you with a copy of the report which the decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you your driving history or safety report, Prewitt and Son Trucking Company will notify you that the action has been taken and that the action was based in part or in whole on this report.
When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prewitt and Son Trucking Company uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding. you, Prewitt and Son Trucking Company must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision or take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, Prewitt and Son Trucking Company must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act.
Neither Prewitt and Son Trucking Company nor FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to: https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication.
Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported ot FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report.
Prewitt and Son Trucking Company cannot obtain background reports from FMCSA without your authorization.
AUTHORIZATION
If you agree that Prewitt and Son Trucking Company may obtain such background reports, please read the following and submit your agreement below:
I authorize Prewitt and Son Trucking Company to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information including crash data from the previous 5 years and inspection history from the previous 3 years. I understand and acknowledge that this release of information may assist Prewitt and Son Trucking Company to make a determination regarding my suitability as an employee.
I further understand that neither Prewitt and Son Trucking Company nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to: https://dataqs.fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand request will be forwarded by the DataQs system to the appropriate State for adjudication.
I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include al CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand al inspections, with or without violations, will appear no my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report.
I have read the above Disclosure Regarding Background Reports provided to me by Prewitt and Son Trucking Company and I understand that if I agree to this Disclosure and Authorization, Prewitt and Son Trucking Company may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above.