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Get Fmcsa Applicant Authorization To Release Safety Permormance History

Clearly) Social Security #: Date of Birth: I, , do hereby authorize you to release the following information to K&K, Inc & Panhandle Employers Services, Inc. (agent) for the purposes of investigation as required by Section 391.23 of the Federal Motor Carrier Safety Regulations. Check this box if you have NOT performed DOT functions in the past three years. Signature.

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