entering my name here I authorize the release of any information, including all information related to my alcohol and controlled substances testing
and training records, by any past or current employers to Shippers Rental Company. I hereby release all such persons from any liability or damages:
(type name in box)
License Ever Been Revoked?
Violation Last 3 Years
experience with each type of trailer:
I hereby certify that all information on this form is correct and complete
to the best of my knowledge. I hereby authorize Sharkey Transportation,
Inc. to do a complete background investigation in accordance with state
and federal laws.
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