JJ KELLER part description

  • Helps you satisfy 49 CFR Section 391.23(d), which requires the prospective employer to obtain driver identification, employment verification, and accident information from a driver/applicant's previous employer(s)
  • Covers the following:
    • Driver/applicant's authorization to release information
    • Employment verification and accident information (including date, location, injuries, fatalities, hazardous material spill details)
  • Snap-out format
  • Twp plies
  • Carbonless
  • Measures 8-1/2" x 11"

Note: This form does not include questions about drug/alcohol testing

JJ Keller® is an industry expert in safety and compliance. It provides organizations of all sizes with the right tools and expert advice to create productive, safe, and compliant workplaces. While it does offer managed and consulting services regarding safety and compliance for DOT regulations, it also supplies a wide range of training materials and tools and a comprehensive list of digital and printed publications, forms, and supplies. DOT compliance for fleets has never been easy with JJ Keller. Its wide assortment of decals, placards, and flags helps keep employees and drivers safe and in compliance while on the job.

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