Get Release Of Information 1020a Form - Ehs Uci

This guide will assist you in completing the Release Of Information 1020A Form online. By following these steps, you will be able to accurately provide the necessary information for your prospective employer and ensure compliance with relevant regulations.

Follow the steps to successfully complete the form online.

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. Begin by entering the prospective employer’s name in the designated field.
3. Provide your name in the 'Applicant' section, ensuring it is printed clearly.
4. Input your social security number in the appropriate field, keeping this information secure.
5. List all DOT-regulated employers where you utilized your Class A or Class B license in the last three years. If more than three employers need to be listed, a separate form must be filled out for each.
6. For each employer, enter the following details: Previous employer name, address, phone number, fax number, contact name, and employment dates.
7. Respond to the question regarding whether you have tested positive or refused to test on any pre-employment drug or alcohol test within the last three years. Select 'YES' or 'NO'.
8. If you answered 'YES' to the previous question, specify whether you have successfully completed DOT return-to-duty requirements by selecting 'YES', 'NO', or 'Not Applicable'.
9. Read the statement regarding the release of information from DOT-regulated drug and alcohol testing records. Confirm your understanding and correct information by signing and dating the form.
10. Repeat the process for the safety performance history section, providing the same details for your driving records as needed.
11. After completing the form, you can save changes, download a copy, print it, or share it as required.

Start filling out your documents online today to ensure a smooth submission process.