Driver Application — Tactical Trucking Solutions LLC

1

Personal Information

First Name *

Middle Name

Last Name *

Date of Birth *

Social Security Number *

Phone Number *

Alternate Phone

Email Address *

Current Street Address *

City *

State *

ZIP Code *

Have you ever been known by any other name?

Yes No

If yes, list other names used

2

CDL & Driver's License

Driver's License Number *

Issuing State *

License Class *

Expiration Date *

Medical Card Expiry

CDL Endorsements (check all that apply)

H – Hazardous Materials N – Tank Vehicles P – Passenger S – School Bus T – Double/Triple Trailers X – Combo Tank + HazMat

Do you have a valid Medical Examiner's Certificate (DOT Physical)? *

Yes No

List ALL states where you have held a driver's license in the past 3 years (per FMCSR 391.21)

Other States Licensed

Driver's License — Front *

📄

Click to upload front of DL

JPG, PNG or PDF · Max 15MB

Driver's License — Back *

📄

Click to upload back of DL

JPG, PNG or PDF · Max 15MB

Has any license ever been suspended, revoked, or denied? *

Yes No

If yes, explain (dates, reason, state)

3

Equipment Experience

Total Years Driving Commercial *

Miles Driven (Approx. Total)

Types of Freight Hauled

Additional Equipment Skills or Certifications

4

Employment History — Last 10 Years

Per FMCSR 391.21, all applicants must provide a complete 10-year employment history. List most recent employer first. Include ALL gaps in employment.

Employer #1 (Most Recent)

Company Name *

Position / Title *

City, State *

Supervisor Name

Phone Number

May We Contact? *

From (Date) *

To (Date) *

Reason for Leaving *

Subject to FMCSR?

Yes No

Were you subject to drug/alcohol testing at this employer?

Yes No

Employer #2

Company Name

Position / Title

City, State

Phone Number

From (Date)

To (Date)

Reason for Leaving

Subject to FMCSR?

Yes No

Employer #3

Company Name

Position / Title

City, State

Phone Number

From (Date)

To (Date)

Any gaps in employment during the past 10 years? Please explain.

5

Accident & Violation History — Last 3 Years

Per FMCSR 391.27, all accidents and moving violations for the past 3 years must be disclosed.

Have you been involved in any accidents in the last 3 years? *

Yes No

If yes — Date, Location, Description, Injuries/Fatalities

Have you received any traffic citations or violations in the last 3 years? *

Yes No

If yes — Date, Violation Type, State, Fine Amount

6

Drug & Alcohol Testing History (FMCSR 382)

Federal law requires all applicants to disclose drug/alcohol testing history per 49 CFR Part 382.

Have you ever tested positive or refused to test for drugs/alcohol? *

Yes No

If yes, have you completed a SAP (Substance Abuse Professional) return-to-duty program?

Yes No N/A

Are you currently enrolled in a random drug & alcohol testing consortium? *

Yes No

Do you consent to pre-employment, random, and post-accident drug/alcohol testing? *

Yes, I consent No

7

General Eligibility

Are you legally eligible to work in the United States? *

Yes No

Are you at least 21 years of age? *

Yes No

Military / Veteran Status

Have you ever been convicted of a felony? *

Yes No

If yes, explain (CA law: convictions may not automatically disqualify you)

How did you hear about us?

8

Certifications & Applicant Signature

I certify that all information provided in this application is true and complete to the best of my knowledge. I understand that any misrepresentation or omission of material facts may result in disqualification from employment or termination if discovered after hire.

I authorize Tactical Trucking Solutions LLC and its agents to investigate all statements contained herein and to obtain a full consumer credit report, driving record, past employment records, and any other information they deem necessary for employment consideration, in accordance with the Fair Credit Reporting Act (FCRA) and California Investigative Consumer Reporting Agencies Act (ICRAA).

I consent to a pre-employment DOT drug screen and background check in accordance with FMCSR 382 and California law. I understand this is not an employment contract.

California applicants: Under California law, criminal history will only be considered to the extent it is related to the job and consistent with business necessity per AB 1008.

Full Legal Name (Typed Signature) *

Date *

I have read, understand, and agree to the above certifications. *