ABBA Global Corp

Personal Information

First Name *

MI

Last Name *

Are you older than 23? *

Yes

No

Phone *

Email *

Date Available *

Legal right to work in US? *

Yes

No

Current Residency

City *

State *

License Information

No person shall have more than one driver's license (49 CFR 383.21)

Current License

Do you have a valid CDL? *

Yes

No

State *

Expiration *

Previously Held Licenses

State

Class

Expiration

State

Class

Expiration

Ever denied a license? *

Yes

No

If yes, explain:

Ever suspended/revoked? *

Yes

No

If yes, explain:

Driving Experience

Total Approximate Miles

Class of Equipment	Type	From Date	To Date	Years

Accident Record

Past 3 years or attach separate sheet

Date	Nature of Accident	Fatalities	Injuries

Traffic Violations

Past 3 years or attach separate sheet

Date	Location	Charge	Penalty

Employment History

List last 3 years in chronological order (most recent first). Account for all gaps.

Current/Most Recent Employer

Company Name *

Position *

From Date *

To Date (or "Present") *

Supervisor *

Phone *

Reason for Leaving *

Subject to DOT regs?

Previous Employer 2

Company Name

Position

From Date

To Date

Supervisor

Phone

Reason for Leaving

Subject to DOT regs?

Previous Employer 3

Company Name

Position

From Date

To Date

Supervisor

Phone

Reason for Leaving

Subject to DOT regs?

California Drivers Only

I authorize California DMV to disclose my driving record to my employer and ABBA Global Corp.

I understand my employer may enroll me in Employer Pull Notice (EPN) program.

I am not driving in capacity requiring mandatory EPN enrollment per CVC §1808.1(k).

Authorization to Obtain Background Information

I authorize ABBA Global Corp and designated third parties to obtain:

• Past Employment References (skills, behavior, experience) per 49 CFR 391.23

• Driving Record History

• Criminal Background Records

Information obtained will be provided to ABBA Global Corp for hiring eligibility based on DOT regulation under part 391 of 49 CFR.

Applicant Certification

I certify that:

• All information provided is true and complete.

• I authorize ABBA Global Corp to investigate my employment, criminal, driving, and medical history.

• I understand false information may result in discharge.

• I authorize contact with current and prior employers for safety performance history (49 CFR 391.23).

• I have the right to review and correct information provided by previous employers.

• I must notify ABBA Global Corp next business day of any license suspension/revocation.

• I must report traffic violations within 30 days (49 CFR 383.31).

• I consent to FMCSA Clearinghouse queries for drug/alcohol violations.

Full Name (Signature) *

Date *

Personal Information

Current Residency

License Information

Current License

Previously Held Licenses

Driving Experience

Accident Record

Traffic Violations

Employment History

California Drivers Only

Authorization to Obtain Background Information

Applicant Certification