Driver Application

This certifies that this application was completed by me, and that all entries on it and information on it are true and complete to the best of my knowledge. I hereby request and authorize MCH Transportation, Inc. and their agents or contractors that receive this application to cause to be conducted, at any time, an investigation of my background for employment purposes, which may include, but is not limited to, any information relating to my character, general reputation, personal characteristics, mode of living, criminal history, past work experience, educational background, alcohol or drug test results, or failure to submit to an alcohol or drug test, or any other information about me which may reect upon my potential for employment gathered from any individual, organization, entity, agency, or other source which may have knowledge concerning any such items of information. I have completed this application of my own free will and hold harmless of all liability all companies, agents and associated parties for the use of this application. As part of our consideration of your application, the DOT requires companies to investigate your employment background. As part of this investigation, they may obtain consumer reports about you from HireRight, Inc. HireRight, Inc. is a consumer reporting agency. Any decision they make not to hire you based on information contained in your consumer report will be their decision alone. HireRight, Inc. does not make any decisions concerning your employment with these companies and will not know the specic reasons why they may decide not to hire you. In the event you are not hired based on information contained in your consumer report, the companies themselves will tell you. We will also advise you of your right to obtain a free copy of the consumer report from HireRight, Inc. and your right to dispute the accuracy or completeness of your report. Your consent for these companies to obtain the report from HireRight, Inc. is required. Although you have a right to withhold your consent, companies will not consider your application if you withhold your consent. I have read the above release and I give permission to obtain consumer reports about me from HireRight, Inc.

I hereby authorize you to release all information concerning my employment including Federal Highway Administration {49CFR, sections 40.25, 382.413, 391.23} drug/alcohol results, oral assessments of my job performance, and fitness to each company that may request such information. I hereby release you from any liability of any type as a result of providing this information to MCH Transportation Company.