DRIVER INFORMATION. If you apply to be a Driver, we will collect the information you provide in your application, including your name, email address, phone number, birth date, profile photo, physical address, government identification number (such as social security number), driver’s license information, vehicle information, and car insurance information. We collect the payment information you provide us, including your bank routing numbers, and tax information. Depending on where you want to drive, we may also ask for additional business license or permit information. We may need additional information from you at some point after you become a Driver, including information to confirm your identity (like a photo). Ratings and Feedback. When you rate and provide feedback about Riders or Drivers, we collect all of the information you provide in your feedback.
DRIVER INFORMATION. 2. 3. Please check the class of CDL that you possess: A B C Please check all applicable Endorsements you possess. H (Hazardous Materials) N (Tank Vehicle) S (School Bus) P (Passenger) PLEASE ATTACH A CLEAR COPY OF YOUR COMMERCIAL DRIVERS LICENSE Before you can be accepted as a WOST driver, you must submit to mandatory drug testing. Please see page 7 for schedule and details. DATE OF DRUG TEST: REGULAR WORKING DAYS: Xxx Xxx Tues Wed Thurs Fri Sat HOURS: to DEPARTMENT DIVISION REGULAR WORK ASSIGNMENT INFORMATION Check if you are a retiree and go to next page. TITLE PAYROLL # UNIT # ECATS USER? WORK ADDRESS No Yes CITY STATE ZIP CODE WORK TELEPHONE # WORK EMAIL ADDRESS FOR DRIVERS - CDL TRAINING ONLY IMPORTANT NOTE: IF YOU ARE INTERESTED IN CDL TRAINING, PLEASE READ AND SIGN BELOW: In consideration for the CDL training expenses paid for by the New Jersey Department of Transportation (NJDOT) and in accordance with its policy and procedures; I agree to participate in the NJDOT winter operations support team program for at least one year after obtaining my CDL. If I do not continue my commitment, I will reimburse NJDOT for the costs involved in the training to obtain my CDL (this amount may vary by region but is approximately $650.00). Costs of the CDL may be waived at the discretion of the NJDOT based on circumstances which management recognizes as compelling (illness, relocation of spouse, military obligations, etc.) THE COST OF THE TEST PERMIT AND THE CDL LICENSE IS THE RESPONSIBILITY OF THE APPLICANT. By checking here, I am agreeing to the above statements and I am requesting CDL Training. FOR OPS (SNOW) REPRESENTATIVES MEMBERS ONLY Check type of vehicle you will be utilizing STATE ASSIGNED PERSONAL NOTE: If you are utilizing a personal vehicle, you must attach a copy of the following: Face sheet of insurance policy i.e. Declarations Page* Proof of valid driver's license *Must show that you maintain insurance for personal liability in minimum amounts of twenty-five thousand dollars ($25,000.00) for each person, fifty thousand dollars ($50,000.00) for each accident, and ten thousand dollars ($10,000.00) for property damage for each accident.. Have you ever submitted mileage reimbursement through the State of New Jersey? No Yes Don't Know I understand that as a snow representative, I will not be eligible for mileage reimbursement for commuting to my assigned snow section. FOR ALL MEMBERS - Signed Agreement is due back to your coordinator no later than August 1...
DRIVER INFORMATION. A Third-Party Tester, instructor, examiner, or employee is prohibited from obtaining or using personal information concerning all license applicants or using personal information concerning any license applicant for purposes of surveys, marketing or solicitation, or in any way prohibited by 18 USC 2721-2725 or AS 28.10.505. Driver, vehicle information and records obtained from a state are subject to the restrictions imposed by applicable federal, state and local privacy protection laws including 18 USC 2721-2725 or AS
DRIVER INFORMATION. (FOR NON-DELIVERY RENTALS) Renter understands that a copy of the driver's current license and insurance certificates must be presented BEFORE departure. You must be 25 years of age or older to rent an RV from COAST 2 COAST RV RENTAL, LLC. All persons driving/ towing the RV must provide copies of current licenses no later than when the RV is picked up.
DRIVER INFORMATION. 4.1 The Driver consents to GT using and disclosing their Driver Information for the purposes of the delivering the GT Services to Users and User Passengers, including sharing it with the Transport Service Provider and Users.
DRIVER INFORMATION. Prior to the commencement of the Hire Period the Hirer will provide the Owner with all information required by the relevant legislation for those persons who will operate the Motor Vehicle for or on behalf of the Hirer. The Owner is also permitted to take a copy of any drivers’ licences at the commencement of the Hire Period.
DRIVER INFORMATION. Primary Driver Name: Contact: Licence Number: Class: Copy of licence attached? Yes / No Secondary Driver (if applicable) Name: Contact: Licence Number: Class: Copy of licence attached? Yes / No
DRIVER INFORMATION. NAME ....................................................................................................................................... (Last) (First) (Other) ADDRESS ................................................................................................................................. (Number & Street) (Municipality) (Province) (Telephone) LICENSE NO. …………………………….…………… PROV. ......................................... DRIVER’S DATE OF BIRTH …………... ……….…..... …….…..... SEX ..................... day month year EXECUTIVE COUNCIL 11 DECEMBER 2018 NSC NO. ................................................
DRIVER INFORMATION. NAME ....................................................................................................................................... (Last) (First) (Other) ADDRESS ................................................................................................................................. (Number & Street) (Municipality) (Province) (Telephone) LICENSE NO. …………………………….…………… PROV. ......................................... DRIVER’S DATE OF BIRTH …………... ……….…..... …….…..... SEX ..................... day month year VEHICLE INFO ....................................................................................................................... (Plate No.) (Year) (Make) (Province) LOCATION .......................................... DATE …... .……... …….. TIME ........................ day month year B.1 NOTICE OF 90-DAY DRIVING PROHIBITION (FOR DRIVER OTHER THAN A GRADUATED DRIVER OR DRIVER UNDER THE AGE OF 19 YEARS OR 22 YEARS, AS APPLICABLE) This is official notification that you are prohibited from operating a motor vehicle for a period of 90 days from under the authority of section 277.2 of the Highway Traffic Act. REASON: The undersigned peace officer has reasonable grounds to believe that on or about ................................................ you operated a motor vehicle or had care or control of a motor vehicle and ’ you did so while your ability to operate the motor vehicle was impaired by alcohol, a drug or a combination of alcohol and a drug (clause 277.2(1)(a) of the Highway Traffic Act); EXECUTIVE COUNCIL 11 DECEMBER 2018 ’ you did so having, as shown by an analysis of your breath or blood, consumed alcohol in such a quantity that the concentration of alcohol in your blood equalled or exceeded 80 milligrams of alcohol in 100 millilitres of blood (clause 277.2(1)(b) of the Highway Traffic Act); ’ you did so having, as shown by an analysis of your bodily substance(s), a blood drug concentration that equalled or exceeded any blood drug concentration for the drug prescribed under the Criminal Code (clause 277.2(1)(c) of the Highway Traffic Act); ’ you did so having, as shown by an analysis of your breath, blood or other bodily substance(s), a blood alcohol concentration and a blood drug concentration that equalled or exceeded the concentrations prescribed under the Criminal Code for the alcohol-drug combination (clause 277.2(1)(c.1) of the Highway Traffic Act); or ’ you failed or refused, without a reasonable excuse, to comply with a d...
DRIVER INFORMATION
