R+L Carriers Shared Services, LLC, it’s affiliates and subsidiaries, (hereinafter “R+L Carriers”) hereby informs you that, in conformance with the Fair Credit Reporting Act, a consumer report concerning your character, general reputation, and personal characteristics may be requested from a consumer reporting agency. You may then inspect and receive a copy of the report by contacting the agency directly. If you are denied employment because of information contained in the report, you will also be advised and the name and address of the agency will be supplied.
R+L Carriers hereby informs you that the information provided by you on this form may be used, and your previous employers may be contacted, for the purpose of investigating your safety performance history information as required by paragraphs (d) and (e) of FMCSR s. 391.23. You are hereby notified of your due process rights as specified in FMCSR s. 391.23(i) regarding information received as a result of these investigations, including the right to review information provided by previous employers, the right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to R+L Carriers, and the right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and you cannot agree on the accuracy of the information.
R+L Carriers may obtain reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration Pre-Employment Screen Program (FMCSA). If R+L Carriers makes a decision to not hire you or takes any adverse action against you based upon your driving history or safety report, R+L Carriers will notify you.
I authorize R+L Carriers to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am consenting to the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist R+L Carriers in making a determination regarding my suitability as an employee.
I further understand that neither R+L Carriers 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 am challenging crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication.
AUTHORIZATION AND RELEASE: I hereby authorize the release of information held by any party regarding my prior employment, credit history, driving record or education to R+L Carriers. I hereby release said persons, companies, law enforcement authorities, and schools from any liability for any damage whatsoever resulting from issuance of the information.
CERTIFICATION: I certify 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. I hereby authorize R+L Carriers to investigate and verify all statements herein contained, and I understand that any misrepresentation, falsification, or omission shall be sufficient reason for dismissal or a refusal of employment.
AT-WILL EMPLOYMENT: I understand that employment at R+L Carriers is at will and is not guaranteed for any term, and may be terminated by R+L Carriers at any time and for any reason. I also understand that no representative of R+L Carriers has the authority to enter into any agreement for employment for any specified period of time, and that I have not and will not rely on any contrary oral representation. I further understand that I am not obligated to work for R+L Carriers for any specified period of time.
Your electronic signature below indicates your agreement with the following statements:
By typing my name in the following box, I certify the above statements to be true and accurate, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application.