Suttles Truck Leasing, Inc.
2460 Highway 43 South
Demopolis, AL 36732

I certify that I have read, understood, and personally completed all of this application. The information that I have provided on this application Is true and complete to the best of my knowledge. Any misrepresentation or omission of any fact in my application, resume, or any other materials, or during any interviews, will be justification for refusal of employment or of a contractor agreement, or if already employed or contracted, terminated from the company's employ or from the company's Independent Contractor program. In consideration of my application, I authorize this Company and/or its agents to conduct a thorough investigation of my past employment history, education, character and mode of living, and release this Company, including its officers, employees, agents, and representatives, from all liability or responsibility related to this investigation including, but not limited to, the performance of drug tests or medical examinations, reference checks, credit or consumer investigations, and criminal and driving histories. I authorize all of my present and former employers and those individuals I have listed as personal references to furnish information about my employment record, including a statement of the reason for termination of my employment, work performance, abilities, and other qualities pertinent to my qualifications for employment, and hereby release them from any and all liability for damages arising from furnishing the requested information. I understand that as an applicant for a position with this Company, or as an Independent Contractor with this Company, I may be asked to demonstrate that I am capable of performing tasks that are pertinent to the job. I am aware that I have the following rights: to review information provided by previous employers; to have errors in the information corrected by the previous employer and for that previous employer to resend the corrected information to the prospective employer; to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and I cannot agree on the accuracy of the information. I understand that as a condition of employment, or as a condition of working as an Independent Contractor, I may be required to undergo and successfully pass a screening for alcohol and/or drugs. I agree and consent to give specimens of blood, breath, hair, urine and/or saliva to any medical facility, laboratory, medical personnel, or any other person authorized by the Company to receive any such specimen. I acknowledge that these specimens shall be used to detect the presence, or prior use of, alcohol, marijuana and other narcotics or drugs in my body. I hereby consent to allowing disclosure to the Company or its agents the results of any such alcohol or drug screening that I may be required to undergo. The results of such tests will be considered in determining my suitability for employment or as an Independent Contractor for this Company.

By Clicking the "Submit" button below you agree that you are giving your express written consent to be contacted via phone call, email and/or text by The Dana Companies., elitedriverjobs.com or JobMAX 360 for any trucking related product from PMG Marketing, LLC, on behalf of any third party & the JobMMAX 360 network at the number(s) and/or email address you provided. You understand that these calls, text and/or email messages may be generated using an automated technology.

*

Please read carefully and completely before signing
DISCLOSURE AND CONSENT

DISCLOSURE

A consumer report and a criminal background report may be procured by Suttles or any of its affiliates, hereinafter referred to as Suttles to qualify a potential applicant, and to periodically obtain updated reports in the event that I am hired or contracted with Suttles. These reports will be reviewed by Suttles, but such reports and the information contained therein shall not be shared with or provided to any third party without my consent or as may be required under applicable law.

I have been provided with the disclosure as required by the Fair Credit Reporting Act (the FCRA) that a consumer report, including information as to character, general reputation, person characteristics, and a mode of living, whichever are applicable, may be procured from time to time. Such reports may contain public information concerning my driving record, workers compensation claims, criminal records, etc., from federal, state and other agencies, which maintain such records

CONSENT

This signed Consent is my authorization and consent for Suttles to procure consumer and criminal background reports as may be required by the U.S. Department of Transportation, Motor Carrier Safety Regulations (49 C.F.R. 391.23) and Suttles. I understand and agree that I am subject to a consumer investigation report to determine my eligibility, and continued eligibility, and I specifically authorize the release, without any liability to Suttles whatsoever, of any findings for those purposes only.

I further understand and agree that consumer and criminal background reports are an absolute and unconditional condition precedent to acceptance or approval by Suttles of my application for qualification and continued qualification, and the results of those reports may also in the sole and absolute discretion of Suttles, constitute grounds for rejection or disqualification. However, should the information received in the consumer report be adverse and reason in whole or in part for denial or disqualification, a copy of the adverse report will be provided to me upon my written request. Should I dispute the information obtained from the Consumer Reporting Agency (CRA), I have the right to obtain a free disclosure of the consumer report if the report is requested within 60 days. Should I dispute the accuracy or completeness of any information provided by the CRA, I can dispute the inaccurate items with the source of information.

I acknowledge and confirm that obtaining the reports and information are reasonable and necessary in order to determine my qualifications and competency as a potential employee or contractor for Wellborn and for Suttles to periodically obtain updated reports in the event I should qualify as an employee or contractor with Suttles.

This authorization shall remain on file and shall serve as on-going authorization for Suttles to procure consumer and criminal background reports at any time during my relationship with Suttles and the qualification process with respect thereto. I understand that upon termination of my relationship as an employee or contractor with Suttles, this authorization shall be destroyed and of no further effect.

I hereby certify that I have read the foregoing and understand the contents of the Disclosure and Consent herein. I also understand the remedies available to me should I disagree with the CRA with respect to the consumer report.

THE BELOW DISCLOSURE AND AUTHORIZATION LANGUAGE IS FOR MANDATORY USE BY
ALL ACCOUNT HOLDERS

IMPORTANT DISCLOSURE
REGARDING BACKGROUND REPORTS FROM THE PSP Online Service
In connection with your application for employment with Suttles (“Prospective Employer”), Prospective Employer, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA).
When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report.

When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act.

Neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication.

Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report.

The Prospective Employer cannot obtain background reports from FMCSA without your authorization.

AUTHORIZATION

If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:
I authorize Suttles (“Prospective Employer”) to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am authorizing the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee.

I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication.

I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear on my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report. I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this Disclosure and Authorization, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above.

NOTICE: This form is made available to monthly account holders by NIC on behalf of the U.S. Department of Transportation, Federal Motor Carrier Safety Administration (FMCSA). Account holders are required by federal law to obtain an Applicant’s written or electronic consent prior to accessing the Applicant’s PSP report. Further, account holders are required by FMCSA to use the language contained in this Disclosure and Authorization form to obtain an Applicant’s consent. The language must be used in whole, exactly as provided. Further, the language on this form must exist as one stand-alone document. The language may NOT be included with other consent forms or any other language.

Request/Consent for Information from Previous Employer(s)/Carrier(s) For Alcohol and Controlled Substances Testing Records And changes in Parts 390 and 391 of the FMCSA
In accordance with DOT Regulation 49 CFR Part 391.23, I authorize the release of information from my DOT regulated drug and alcohol testing records by the carriers (company/school) listed above to DANA Companies and its affiliates, hereinafter referred to as "Suttles", or to DriverIQ for the sole purpose of transmitting such records to Suttles. I authorize release of the following information concerning DOT drug and alcohol testing violations including pre-employment tests during the past three years: (i) alcohol tests with a result of 0.04 or higher; (ii) verified positive drug tests; (iii) refusals to be tested (including verified adulterated or substituted results); (iv) other violations of DOT drug and alcohol testing regulations; (v) information obtained from previous employers of a drug and alcohol rule violation(s); and (vi) documents, if any, of completion of a return-to-duty process following a rule violation. I also authorize the carriers (company/school) listed above to release information about names and dates of previous employers, reasons for termination of employment, work experience, accidents, academic history, professional credentials and other information. The information that I have authorized Suttles or DriverIQ to review involves tests required by DOT. If any carrier (company/school) listed above furnishes Suttles or DriverIQ with information concerning items (i) through (vi) above, I also authorize that carrier (company/school) to release and furnish the dates of my negative drug and/or alcohol tests and/or tests with results below 0.04 during the three-year period and the name and phone number of any substance abuse professional who evaluated me during the past three years.
1. In connection with your application for employment with Suttels ("Prospective Employer"), Prospective Employer, its employees,
agents or contractors may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety
Administration (FMCSA).

When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to
not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report
upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If
any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action
has been taken and that the action was based in part or in whole on this report.

When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any
information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective
Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been
taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the
FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and
that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of
any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days
of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a
summary of your rights under the Fair Credit Reporting Act.

The Prospective Employer cannot obtain background reports from FMCSA unless you consent in writing.

If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:
2. I authorize Suttles ("Prospective Employer") to access the FMCSA Pre-Employment Screening Program (PSP) system to seek
information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am consenting to
the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3)
years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my
suitability as an employee.
3. I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to
correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to
https://dataqs.fmcsa.dot.gov. If I am challenging crash or inspection information reported by a State, FMCSA cannot change or correct this data. I
understand my request will be forwarded by the DataQs system to the appropriate State for adjudication.
4. Please note: Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or
imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to
FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with FMCSR
violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report.
I have read the above Notice Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this consent form,
Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized
agents, and/or affiliates to obtain the information authorized above.

A Summary of Your Rights Under the Fair Credit Reporting Act

The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.ftc.gov/credit or write to: Consumer Response Center, Room 130-A, Federal Trade Commission, 600 Pennsylvania Ave. N.W., Washington, D.C. 20580.