Previous Three Years Residency
No person who operates a commercial motor vehicle shall at any time have more than one driver's license (49 CFR 383.21). I certify that I do not have more than one motor vehicle license, the information for which is listed below. Includes all licenses held for the past 3 years; attach additional information if needed.
Previously Held Licenses
Tractor & Semi-Trailer
Tractor & 2 Trailers
Tractor & Tanker
Accident Record For The Past 3 Years
Traffic Convictions And Forfeitures For The Past 3 Years (Other Than Parking Violations)
The Federal Motor Carrier Safety Regulations (49 CFR 391.21) require that all applicants wishing to drive a commercial vehicle list all employment for the last three (3) years. In addition, if you have driven a commercial vehicle previously, you must provide employment history for an additional seven (7) years (for a total of ten (10) years). Any gaps in employment in excess of one (1) month must be explained.
Start with the last or current position, including any military experience, and work backwards (attach separate sheets if necessary). You are required to list the complete mailing address, including street number, city, state, zip; and complete all other information.
Second (most recent) Employer
Third (most recent) Employer
To Be Read And Signed By Applicant