Driver Application
& Compliance Forms

I hereby authorize each of the employers listed above to release to Gateway Logistics LLC any and all information regarding my employment, including but not limited to: dates of employment, job performance, accidents, traffic convictions, alcohol/drug violations, and any other safety performance history as required by 49 CFR Part 391. I release all parties from liability in connection with the release of such information.

I, the undersigned, hereby authorize Gateway Logistics LLC, its employees, agents, and designated representatives to obtain my Motor Vehicle Record (MVR) from the Department of Motor Vehicles (DMV) or equivalent licensing authority of any and all states listed above, and any other state in which I have held a driver's license in the past three (3) years.

I understand this record may include information regarding my driving history, including but not limited to: moving violations, accidents, DUI/DWI convictions, license suspensions or revocations, and other matters of record. I authorize the release of this information solely for the purpose of evaluating my qualification for employment as a commercial motor vehicle driver, in compliance with 49 CFR Part 391.

I certify that the information provided is true and accurate to the best of my knowledge.

Full Query Authorization:
I, the undersigned CDL holder, hereby provide my consent to Gateway Logistics LLC (USDOT #: 4139366) to conduct a Full Query of the Federal Motor Carrier Safety Administration (FMCSA) Commercial Driver's License Drug and Alcohol Clearinghouse to obtain information about my drug and alcohol program violations as defined in 49 CFR Part 382.

I understand that:
• This query will reveal information about violations of FMCSA drug and alcohol testing requirements, including positive test results, refusals to test, and return-to-duty status.
• This information will be used solely to evaluate my eligibility and qualifications to operate a commercial motor vehicle for Gateway Logistics LLC.
• I have the right to review information obtained through this query.
• I may contact the Clearinghouse at clearinghouse.fmcsa.dot.gov to review my own record.
• This consent is valid for a period of 30 days from the date of signature below and applies only to the employer named above.

By signing above, I certify under penalty of perjury that all information provided in this application and all attached forms is true, accurate, and complete to the best of my knowledge. I understand that any material misrepresentation or omission may result in immediate disqualification or termination.

In connection with your application for employment with Gateway Logistics LLC ("Prospective Employer"), Prospective Employer, 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 the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its 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 based upon your driving history or safety report, the Prospective Employer 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 Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer 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 to 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, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act.

Neither the Prospective Employer nor the 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 to 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.

The Prospective Employer cannot obtain background reports from FMCSA without your authorization.

If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:

I authorize Gateway Logistics LLC ("Prospective Employer") 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 authorizing 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 the Prospective Employer to make a determination regarding my suitability as an employee.

I further understand that neither the Prospective Employer 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 my 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 all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear on 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 Prospective Employer and I understand that if I sign this Disclosure and Authorization, Prospective Employer 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.