Get Fmcsa Applicant Authorization To Release Safety Permormance History

The FMCSA Applicant Authorization to Release Safety Performance History is a crucial document for individuals seeking employment that involves operating a commercial motor vehicle. This guide provides clear instructions on completing the form online, ensuring all necessary information is accurately recorded.

Follow the steps to complete the form efficiently.

1. Click ‘Get Form’ button to obtain the form, initiating the process of accessing the document.
2. Begin by clearly printing your name in the designated field labeled ‘Name of Applicant’.
3. Enter your Social Security number in the appropriate section followed by your date of birth.
4. In the authorization statement, write your name again as the applicant authorizing the release of safety performance history to K&K, Inc & Panhandle Employers Services, Inc.
5. If you have not performed DOT functions in the past three years, check the provided box.
6. Sign the form in the section marked ‘Signature of Applicant’ and date it.
7. Provide the previous employer's information, including their name, address, city, state, and zip code. Ensure accuracy in the phone and fax numbers.
8. Indicate the position you applied for in the field labeled ‘position’ and complete the dates of employment at your previous job.
9. For the previous employer, confirm whether the applicant has driven a commercial motor vehicle and specify the type if applicable.
10. Choose the reason for leaving the previous employment from the provided options.
11. Complete the accident history section, noting any accidents involving the applicant in the past three years, including the date, location, number of injuries, and fatalities.
12. Provide any additional remarks as necessary.
13. Obtain the signature and title of the representative from the previous employer and include the date.
14. Once all sections are completed, you can save the form, download it, print, or share as required.

Complete your FMCSA documents online now to streamline your job application process.