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By utilizing AllTruckJobs and submitting this electronic release form, I authorize track5media, as owner of AllTruckJobs, to facilitate the release of any and all information and records to any potential employer from prior employers and third parties pertaining to my work history, evaluations, disciplinary action and benefit information, including, but not limited to, my driving record, safety performance record, alcohol and drug testing information, and criminal background records that may be on file with any former employer or with the applicable federal and state Departments of Transportation, including, but not limited to, the Federal Motor Carrier Safety Administration (FMCSA). I understand that if a potential employer decides not to hire me or makes an adverse employment decision based on information obtained through the FMCSA, the potential employer must provide me a copy of the report on which the decision was based and provide me a summary of my rights under the Fair Credit Reporting Act (FCRA). In addition, my potential employer must alert me within three (3) business days of taking the adverse action as to any adverse information from the FMCSA report used to disqualify me for the job. I understand that this report may report crashes I was involved, regardless of whether I was at fault, inspections, and citations or other violations associated with my driving history. I understand that certain state transportation departments may require me to sign a request for driver information before such information can be requested, and I agree to fully cooperate with AllTruckJobs and my potential employer in accessing my driving information. In addition, I understand that track5media and AllTruckJobs are not account holders for purpose of the FMCSA's Pre-Employment Screening Program (PSP) which may be utilized by a potential employer as an "account holder" under its PSP to access background reports regarding my driving and safety inspection history from FMCSA; track5media and AllTruckJobs are mere facilitators for a potential employer to apply and obtain this background information. As a facilitator, I acknowledge that track5media and AllTruckJobs is asking me to sign the "Important Disclosure" required by FMCSA for a potential employer to access my background information which disclosure will be provided to my potential employer.

As used with this authorization/release, "employer" shall denote employer or one for who services were provided under an independent contractor relationship.

I understand that if I do not consent to the release of the aforementioned, that it may disqualify me from a trucking position with a desired employer.

I hereby release track5media or any party utilizing the foregoing information in considering my employment or agency, or any custodian of such records, including any action taken by the party using or retaining custody of such records. By electronically signing this release and authorization, I affirm that I am aware of my rights and obligations under applicable law pertaining to the release of employment information.

By entering your name above, you are electronically signing this release form.

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