PRIOR EMPLOYER VERIFICATION INQUIRY
Driver safety history and employment inquiry form · 49 CFR 391.23
| Driver Name | Driver ID | CDL Number |
|---|
| John Carter | DRV-001 | OH1668243 |
| Address | Phone | Email |
|---|
| 1240 W 6th St, Cleveland, OH 44113 | 206-667-3424 | jcarter@yahoo.com |
| Prior Carrier Name | Employment Period | Reason for Leaving |
|---|
| Northline Freight LLC | 2022-01 to 2024-09 | Career advancement |
| Accident History Provided | Drug/Alcohol Violations | Eligible for Rehire |
|---|
| No reportable incidents in previous 36 months | No violations reported | Yes |
Michael Brown
Delta Advanced Trucking, Inc. Safety Officer Signature
James Wilson
Prior Carrier Representative Signature
John Carter
Driver Consent Signature · 2026-05-10