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Safety Performance History Records Request - Snap-Out Format
Features 3-ply forms (8-1/2" x 11-3/4") with carbon copy. Read more.
Starting at:
$1.08403
$1.08403
Effective January 6, 2023: Motor carriers will no longer need to contact a CDL driver’s former employers to inquire about FMCSA drug or alcohol testing violations. Motor carriers must run a Drug & Alcohol Clearinghouse query instead. Former employers must still be contacted for employment verification and the driver’s crash history. Therefore, drug/alcohol questions have been removed from the Safety Performance History Records Request form (No. 9620 or 9652). The revised Previous Employer Alcohol & Drug Test Information form (No. 6827 or 6828) should be used to obtain information about an applicant’s DOT drug or alcohol violations that occurred under a non-FMCSA agency (FAA, FTA, FRA, PHMSA, etc.).
Product Code:
9620
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Overview
- Use to help satisfy 49 CFR §391.23(a)(2), (d), and (e), which require the prospective employer to obtain driver identification, employment and accident history from a driver/applicant's previous employers
- Covers driver/applicant's authorization to release information; employment verification and accident information
- Snap-out format
- Three plies
- Carbon copy
- Measures 8-1/2" x 11-3/4"
- Imprinting available. Call toll-free for pricing.
Volume Pricing
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9620
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Snap-out format, carbon copy, 8-1/2" x 11-3/4"
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$1.08403
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$1.04053
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$0.82112
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Specification
| Product Code | Description | Format | Number of Plies | Size | Need to Purchase a Case? | Country Of Origin |
|---|---|---|---|---|---|---|
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9620
|
Snap-out format, carbon copy, 8-1/2" x 11-3/4"
|
Snap-out
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3
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8.5" x 11.75"
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1,000 per case
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USA
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