109 W. Dicker Rd. Suite B San Juan, Tx. 78589
956-702-8000

Step 1: please fill the Form Below

Note: Please fill application using a computer not mobile phone

Current Address

Previous Three Years Residency

Address 1:
Address 2:
Address 3:

License Information

Section 383.21 FMCSR states "No person who operates a commercial motor vehicle shall at any time have more than one driver's licence". I certify that I do not have more than one motor vehicle licence, the information for which is listed below.

Driving Experience

Class of Equipment
Type of Equipment
Dates
Approx. No. of Miles
Straight Truck
Tractor & Semi-Trailer
Tractor - Two Trailers
Other

Accident Record for the Past 3 Years

Date

Date Accident Took Place

Nature of Accident

Head on, Rear-End, Upset?

Number of Fatalities

Indicate # of Fatalities

Injuries

Indicate # Injured

Chemical Spill

Yes or No

Traffic Violations and Forfeitures for the Past 3 Years

Date Convicted

Month/Year

Violation

Type of Violation

State of Violation

Location

Penalty

Forfeit Bond, Collateral / Points

A. Have you ever been denied a license, permit or privilege to operate a motor vehicle?
B. Has any license, permit or privilege ever been suspended or revoked?

Employment Record

Must list the complete mailing address: Street Number, city, state and zipcode

Were you subject to Federal Motor Carrier Safety Regulations (FMCSR) while employed by previous employer?

Was the previous job designated as a safety function in any DOT regulated mode,subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40


Were you subject to Federal Motor Carrier Safety Regulations (FMCSR) while employed by previous employer?

Was the previous job designated as a safety function in any DOT regulated mode,subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40


Were you subject to Federal Motor Carrier Safety Regulations (FMCSR) while employed by previous employer?

Was the previous job designated as a safety function in any DOT regulated mode,subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40


Were you subject to Federal Motor Carrier Safety Regulations (FMCSR) while employed by previous employer?

Was the previous job designated as a safety function in any DOT regulated mode,subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40


Were you subject to Federal Motor Carrier Safety Regulations (FMCSR) while employed by previous employer?

Was the previous job designated as a safety function in any DOT regulated mode,subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40


Were you subject to Federal Motor Carrier Safety Regulations (FMCSR) while employed by previous employer?

Was the previous job designated as a safety function in any DOT regulated mode,subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40


Were you subject to Federal Motor Carrier Safety Regulations (FMCSR) while employed by previous employer?

Was the previous job designated as a safety function in any DOT regulated mode,subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40


Were you subject to Federal Motor Carrier Safety Regulations (FMCSR) while employed by previous employer?

Was the previous job designated as a safety function in any DOT regulated mode,subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40


Were you subject to Federal Motor Carrier Safety Regulations (FMCSR) while employed by previous employer?

Was the previous job designated as a safety function in any DOT regulated mode,subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40


Were you subject to Federal Motor Carrier Safety Regulations (FMCSR) while employed by previous employer?

Was the previous job designated as a safety function in any DOT regulated mode,subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40

Step 2: Download and Fill the form Below.

You can drop off the form at 109 W. Dicker Rd. Suite B, San Juan, Tx. 78589

Click Here to Download Employment Application