Company Driver Application

It is agreed and understood that any misrepresentation given on this application shall be considered an act of dishonesty. It is agreed and understood that the motor carrier or his agents may investigate the applicant's background to ascertain any and all information of concern to applicant's record, whether same is of record or not, and applicant releases employers and persons named herein from all liability for any damages on account of his furnishing such information. It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an investigating Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living. I agree to furnish such additional information and complete such examinations as may be required to complete my application file. It is agreed and understood that this Application for Qualification in no way obligates the motor carrier to employ or hire the applicant. It is agreed and understood that if qualified and hired, I may be on a probationary period during which time I may be disqualified without recourse. This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

Motor carriers have the responsibility to make the following investigations and inquiries with respect to each Driver employed, other than a person who has been a regularly employed driver of the motor carrier for a continuous period which began before January 1, 1971.

• (a) An inquiry into the driver's driving record during the preceding three years of to the appropriate agency of every State in which the driver held a motor vehicle operator's license or permit during those three years; (a)(2) An investigation of the driver's employment record during the preceding three years.
• (b) A copy of the drivers record(s) obtained in response to State driver record agency as required must be in the Driver Qualification file within 30 days date the driver's employment begins and be retained in compliance with 391.51.
• (c) Replies to the investigations of the driver's safety performance history must be placed in the Driver Investigation History file within 30 days of the date the driver's employment begins. This goes into effect after October 29, 2004.
• (d) Prospective motor carrier must investigate the information from all previous employers of the applicant that employed the driver to operate a CMV within the previous three years. This information must cover general driver identification and employment verification information, data elements as specified in 390.15 for accident involving the driver that occurred in the three-year period preceding the date of employment application, and any accidents the previous employer may wish to provide.
• (e) Prospective motor carrier must investigate the information from all previous DOT regulated employers that employed the driver within the previous three years from the date of the employment application in a safety-sensitive function that required alcohol and controlled substance testing specified by 49 CFR Part 40.

Divers have the following rights:

1. The right to review information provided by previous employers.
2. The right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to the prospective employer.
3. The right to have a rebuttal statement attached to the alleged erroneous information, previous employer and the driver cannot agree on the accuracy of the information.

Drivers who wish to review previous employer-provided investigative information must submit a written request to the prospective employer when applying or as late as 30 days after employed or being of denial of employment. The prospective employer must provide this information to applicant five days of receiving the written request. If the driver has not arranged to pick up or receive the records within 30 days of the prospective employer making them available, the prospective motor carrier may consider driver to have waived request to review the records. Drivers wishing to request correction of erroneous information in must send request for the correction to the previous employer that provided records.

After October 29, 20(M, the previous employer must either correct and forward the information to the prospective motor carrier employer or notify the driver within 15 days of receiving the driver's request to correct the data that it does not agree to correct the data. Drivers wishing to rebut information in records must send the rebuttal to the previous employer with instruction to include the rebuttal in the driver's Safety Performance History.

I acknowledge that I have read and understand the contents of this document Drivers

Driver to complete this section As a Commercial Motor Vehicle (CMV) Driver, I understand that per, the Federal Motor Carrier Safety Regulations(FMCSR) Part 391.21, the following information will be requested from all previous employers for which I operated a CMV, subject to the FMCSR Parts390 and or 40,382&383, within the past three years, from date shown below. I also acknowledge that this information will be used to determine my eligibility to be hired, that I have the right to review this information and rebut any errors in these statements from my prior employers, as described in the FMCSR Part 391.23.

I, hereby authorize this company to release all (PRINT NAME) records of employment, including assessments Of my job performance, ability and fitness, including dates of any and alcohol or drug tests. Those confirmed results and or my refusal to submit to any alcohol or drug test and any rehabilitation completion under direction of SAP?MRO to each and every company(or their authorize agents) which may request such information in connection with my application for employment with said company. I hereby release this company, and its employees, officers, directors, and agents from any and all liability of any type as a result of providing information to the above-mentioned person and/or company.

Notice: NYB Ventures Group Inc advises that no workers compensations certificate will be furnished to Driver and settlement for insurance will not be applicable under provisions of the following: Hold Harmless Agreement This will serve as evidence that Driver will assume all responsibility for worker's compensation coverage insurance for any loads tendered on behalf of NYB Ventures Group Inc.