Confidential All-In-One Driver Qualification Packet (Single Copy) (00101)
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Confidential All-In-One Driver Qualification Packet (Single Copy)

Helps you comply with the Safety Performance History recordkeeping requirement Read more.

Product Code: 9647
List Price: $21.88
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Overview

NOTICE: The latest Medical Examiner’s Certificates show an OMB expiration date of 11/30/2021 in the upper-right corner. On Dec. 4, 2018, the Federal Motor Carrier Safety Administration (FMCSA) informed us that there is no specific deadline when forms dated 8/31/2018 or 9/30/2019 can no longer be used, though they do “suggest” that the 2019 or 2021 versions be used in place of the 2018 version. The FMCSA also announced that it “is encouraging the State Driver's Licensing Agencies (SDLAs) to accept these forms with expiration dates of 08/31/2018, 09/30/2019, and 11/30/2021.” Therefore, all three versions remain acceptable but upgrading to the 2019 or 2021 versions is advised.


  • Allows you to keep Alcohol & Drug Forms, Safety Performance History Forms and Driver Qualification Forms secure and in one convenient location
  • Each file packet includes a 9-1/2" W x 11-3/4" file folder and the following forms:

    Driver Qualification

    • (1) Driver Qualification File Contents Sheet - Bond (426-F-P)
    • (1) Driver's Application for Employment - Bond (691)
    • (1) Additional Employment History Information - Bond (4318)
    • (1) Request For Check of Driving Record - Bond (*506540)
    • (1) Medical Examination Report - Bond (47375)
    • (1) Medical Examiner's Certificate - Laminated Wallet Card (47379)
    • (1) Medical Examiner's National Registry Verification - Bond (27033)
    • (1) Record of Road Test - Bond (652)
    • (1) Certification of Violations/Annual Review of Driving Record - Bond (3685)
    • (1) Driver's Statement of On-Duty Hours-New Hire - Bond (3687)
    • (1) Certification of Compliance with Driver License Requirements - Bond (1617)
    • (1) Employment Eligibility Verification I-9 - Bond (50306)
    • (1) Certification of Road Test Pocket Card (006-BC)
    • (1) Driver Qualification and Identification Certificate Pocket Card (007-BC)
    • (1) Checklist for Qualification of New Drivers - Bond (*506541)
    • (1) Driver Record Card (3211)

    Alcohol and Drug

    • (1) Previous Pre-Employment Employee Alcohol & Drug Test Statement - 2-Ply Snap-out (6801)
    • (1) Alcohol and Drug Records Request - 3-Ply Snap-out (6826)
    • (1) Alcohol and Drug Employee's Certified Receipt - 2-Ply Snap-out (6793)
    • (1) Alcohol and/or Drug Test Notification - 2-Ply Snap-out (3048)
    • (1) Drug Test Results - 4-Ply Snap-out (6794)
    • (1) Observed Behavior Reasonable Suspicion Record - 3-Ply Snap-out (7218)
    • (1) U.S. Department of Transportation Alcohol Testing Form - 3-Ply Snap-out (6849)
    • (1) Federal Drug Testing Custody and Control Form - 5-ply Continuous Pinfed (6520)
    • (1) Alcohol and Drug Recordkeeping Log - Bond (001-F-P)

    Safety Performance History

    • (3) Safety Performance History Records Request - 3-ply Snap-out (9620)
    • (1) Previous Employee Safety Performance History - Bond (9619)

    *Not sold separately


    Interested in a license to use these forms electronically?
    For a quote to use these forms electronically, such as on your company intranet, or with form-fillable fields, contact us at customsolutions@jjkeller.com or 1-800-327-6868 to discuss. Learn more.

    Volume Pricing

    Volume Pricing
    Product Code Description 1 - 9 10 - 24 25 - 49 50 - 99 100 - 199
    9647
    File Packet
    $21.88
    $16.44
    $15.47
    $13.83
    $11.43

    Specification

    Specification
    Product Code Description Need to Purchase a Case? Size Format Number of Plies
    9647
    File Packet
    60 per case
    11.75" x 9.5"
    Folder
    1

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