Dabney Services
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Employment Forms

Request for Check of Driving Record

NOTE: This form may be used in states that do not require a specific form.
CAUTION: When using a third party to request background information on applicants or existing employees – such as motor vehicle records, information from previous employers, criminal records, or credit history – you are subject to the Fair Credit Reporting Act (FCRA) and State consumer reporting laws. Under FCRA, the third-party vendor is considered a consumer reporting agency (CRA) an the employee background information is a consumer report. Before you can obtain a consumer report from a CRA you must provide a applicants and employees with a disclosure stating that your company may obtain such a report for employment purposes, and you must have authorization from the applicant or employee to conduct the check. You must also provide a copy of the Federal Trade Commission’s notice called “A Summary of Your Rights Under the Fair Credit Reporting Act.” The notice, disclosure, and authorization are not included in this file, and some state laws have additional requirements. Consult with your CRA on the need and use of such documents.

I hereby authorize you to release the following information to Dabney Service, Inc. (Employer) for purposes of investigating as required by Section 391.23 and 391.25 of the Federal Motor Carrier Safety Regulations. You are released from any and all liability which may result from furnishing such information.
I also hereby certify that this request and the above driver’s release notice meet the definition of “permissible uses” of state motor vehicle records under the provisions of the Driver’s Privacy Protection Act of 1994 (Public Law 103-322, Title XXX, Section 300002(a)).
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