Driver & Owner-Operator Applicaton

I am applying as:

CDL-A Driver

Owner Operator

Other Driver Position

First name

Last name

Email

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

CDL/ Driver License Number

State Issued

CDL Class

Class A

Class B

Class C

CDL Expiration Date

Years of Commercial Driving Experience

States Operated In During the Last 5 Years

Special Course or Training Completed

Safe Driving Awards (if any)

Have you been involved in any motor vehicle accidents during the past 3 years?

Yes

No

If yes, provide accident details (date, location, nature of accident, fatalities, and injuries)

Have you had any traffic convictions or forfeitures during the past 3 years (excluding parking violations)?

Yes

No

If yes, provide details of each traffic conviction or forfeiture (date, location, charge, and penalty)

Has any driver's license, permit, or privilege to operate a motor vehicle ever been suspended or revoked?

Yes

No

If yes, provide details of the suspension or revocation

Have you ever been denied a license, permit, or privilege to operate a motor vehicle?

Yes

No

If yes, provide details of the license, permit, or driving privilege denial

Employment & Commercial Driving History

List your employers for the past 3 years and all commercial driving employment for the past 10 years. include employer name, position, dates employed, and reason for leaving.

DOT Medical Certificate Expiration Date

Upload CDL - Front

Upload CDL - Back

Upload DOT Medical Certificate

Truck Year (Owner-Operator Only)

Truck Make & Model (Owner-Operators Only)

Truck VIN (Owner-Operators Only)

Upload Truck Registration & Title (Owner-Operators Only)

Upload Certificate of Insurance (Bobtail) if any

Driver's Licenses Held During the Past 3 Years

List the state, license type/class, endorsements, and expiration date for each license held.

Professional / Safety References

List 3 references other than family members. Include each person's name, phone number, and address.

Truck Photos (Owner-Operators Only)

Front, Rear, both sides, Milleage, and Tires photos should be visible.

Are you able to perform the essential functions of the position for which you are applying, with or without reasonable accommodation?

Yes

No

Have you previously worked with REZWAN GROUP LLC?

Yes

No

If yes, provide dates worked and reason for leaving

Have you previously worked in a position subject to the Federal Motor Carrier Safety Regulations (FMCSRs)?

Yes

No

Have you previously worked in a DOT - regulated safety-sensitive position subject to drug and alcohol testing requirements?

Yes

No

List any previous addresses from the past 3 years, including city, state, zip code, and the dates you lived at each address. If your current address covers full 3 years, enter "N/A"

Emergency Contact Name & Phone Number

Date of Birth

Application Date

I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that providing false or misleading information may result in disqualification from consideration or termination of the relationship.

Applicant Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

I authorize REZWAN GROUP LLC and its authorized agents to verify information provided in this application, including my employment, driving, safety, and other qualification-related records, as permitted by applicable law.