MOTOR CARRIER SAFETY PROGRAM
INQUIRY TO STATE AGENCY FOR DRIVER’S RECORD
391.23
__________________________________________________________
(Driver’s Name)
__________________________________________________________
(Driver’s Operator’s Lic. No.)
__________________________________________________________
(Driver’s Social Sec. No.)
Dear________,
The above listed individual has made application with us for employment as a driver. Applicant has indicated that the above numbered operator’s license or permit has been issued by your State to applicant and that it is in good standing.
In accordance with Section 391.23(a)(1) and (b) of the Federal Motor Carrier Safety Regulations, we are required to make inquiry into the driving record during the preceding 3 years of every State in which an applicant-driver has held a motor vehicle operator’s license or permit during those 3 years.
Therefore, please certify to us what the individual’s driving record is for the preceding 3 years, or certify that no record exists if that be the case.
In the event that this inquiry does not satisfy your requirements for making such inquiries, please send us such forms of yours as are necessary for us to complete our inquiry into the driving record of this individual.
Respectfully Yours,
________________________________________________________
Signature of individual making inquiry
________________________________________________________
(printed)
Name of person making inquiry
Title of person making inquiry
________________________________________________________
Motor Carrier Name
________________________________________________________
Street, City, State, Zip