Request for Alcohol/Controlled Substances Information Form
This document is for commercial motor vehicle drivers applying at D&D Transport. It authorizes the procurement of consumer reports and requests information about previous alcohol and controlled substance test results from past employers. Applicants need to fill out and submit this form to complete the application process.
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How do I fill this out?
Filling out this form is an important step in your application process at D&D Transport. Begin by reading all sections carefully and providing your personal information, signature, and date where indicated. Finally, submit the completed form to D&D Transport as instructed.
How to fill out the Request for Alcohol/Controlled Substances Information Form?
1
Read all sections of the form carefully.
2
Provide your personal information in the designated fields.
3
Sign and date the form where indicated.
4
Ensure that all information is accurate and complete.
5
Submit the form to D&D Transport via fax or mail.
Who needs the Request for Alcohol/Controlled Substances Information Form?
1
Commercial motor vehicle drivers applying at D&D Transport need this form to provide authorization for consumer reports.
2
Employers who are required to verify a driver's past alcohol and controlled substances test results.
3
HR departments to comply with DOT regulations concerning the hiring of commercial drivers.
4
Drivers who need to supply their employment and testing history to a new employer.
5
Safety and compliance officers ensuring that all required documentation is collected during the hiring process.
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What are the instructions for submitting this form?
Submit this form to D&D Transport by either faxing it to 601-693-3661 or mailing it to 4869 Peavey Drive, Meridian, MS 39301. Ensure that all required fields are filled out accurately and completely before submission. If you have questions, contact D&D Transport for further instructions or clarification.
What are the important dates for this form in 2024 and 2025?
Ensure the form is filled and submitted promptly when applying for a position at D&D Transport in 2024 and 2025.
What is the purpose of this form?
The purpose of this form is to authorize D&D Transport to obtain alcohol and controlled substances test information from the applicant's previous employers. This verification process helps ensure that all commercial motor vehicle drivers comply with DOT regulations. By completing and submitting this form, applicants provide the necessary consent and information to facilitate the hiring process.
Tell me about this form and its components and fields line-by-line.
- 1. Driver Applicant Name: This field captures the full name of the driver applicant.
- 2. Driver Applicant Signature: This field requires the applicant's signature for authorization.
- 3. Date: This field captures the date when the form is signed.
- 4. Participated in any alcohol or drug tests?: This field requires past employers to indicate if the applicant has participated in alcohol or drug tests in the past three years.
- 5. Tested positive for controlled substances?: This field requires past employers to indicate if the applicant has tested positive for controlled substances.
- 6. Had a breath alcohol test result of .04 or greater?: This field requires past employers to indicate if the applicant had a breath alcohol test result of .04 or greater.
- 7. Refused a required test for controlled substances or alcohol?: This field requires past employers to indicate if the applicant has refused any required test for controlled substances or alcohol.
- 8. Any other violations of DOT drug / alcohol regulations?: This field requires past employers to indicate any other violations of DOT drug and alcohol regulations.
- 9. Any information received from a previous employer that this individual violated DOT drug / alcohol regulations: This field requires past employers to indicate if they received any information from a previous employer that the applicant violated DOT drug or alcohol regulations.
- 10. Signature of person providing information: This field requires the signature of the person providing the information.
- 11. Title: This field captures the title of the person providing the information.
- 12. Date: This field captures the date when the information is provided.
- 13. Print Company name: This field requires the printed name of the company providing the information.
What happens if I fail to submit this form?
Failing to submit this form can result in your application being incomplete and potential delays in the hiring process.
- Incomplete Application: Your application will be considered incomplete and may not be processed.
- Hiring Delays: Submitting this form late can lead to delays in the hiring process.
- Failure to Comply with Regulations: Not submitting this form means failing to comply with DOT regulations necessary for employment as a commercial driver.
How do I know when to use this form?
- 1. Job Application: Submit this form as part of your application process at D&D Transport.
- 2. Employment Verification: Used by employers to verify your past controlled substances and alcohol test information.
- 3. Compliance with DOT Regulations: Necessary for ensuring compliance with DOT regulations regarding drug and alcohol testing.
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