• 4848 Riverside Dr.  Laredo,  TX  78041
  • (956) 229-6076

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Driver Application

Application ID: 1502919167

Pan American Express, Inc.
4848 Riverside Dr.
Laredo,  TX  78041
(956) 229-6076
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*If at current address less than seven years, list below most recent addresses for the past seven years.
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How did you hear about Pan American Express, Inc.?:

Commercial Drivers License

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CDL Type
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Air Brake Restriction? *
Endorsements (check all that apply)
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Current DOT Medical Card *

Driving/Hauling Experience

Education

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Additional Licenses

Drivers licenses held in the past 5 years must be shown.

Accident Review for Past 5 Years

Last Accident

Traffic Convictions & Forfeitures for Past 5 Years

Employment History

You must provide accurate dates of employment and phone numbers covering the last ten years (per DOT regulation). We cannot hire you without verifying employment. If you need to list additional employers, click "Add Another Employer" below.
EMPLOYER #1
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Driving/Hauling Experience With This Employer
You can add only 15 employers!

Owner Operator Equipment Form

Tractor

Trailer

Straight Truck

Cargo Van

May we contact current employer?           Yes    No

Authorization

By clicking "Send" below, I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, any falsified statements on this application shall be grounds for dismissal. Under the provisions of the Fair Credit Reporting Act, the Americans With Disabilities Act, the Drivers Privacy Protection Act and all other applicable federal, state, and local laws I authorize investigation of all statements contained herein as well as authorize the references and employers listed to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise.

I hereby release and hold harmless any person, firm, or entity that discloses information in accordance with this authorization, as well as my prospective employer, and its agents, from any liability that may otherwise result from the request for, use of, or disclosure of, any or all of the foregoing information. The above-mentioned investigations may include, but are not limited to, information as to my character, general reputation, work history, or lifestyle, discerned through employment and education verifications; personal references; personal interviews; my personal credit history based on reports from any credit bureau; my driving history, including any traffic citations; a social security number verification; present and former addresses; criminal and civil history records; or any other public record.

I understand that consumer reports which may contain public record information may be requested, at the discretion of my prospective employer, which may include names, dates of employment, reason for termination, work experience, traffic records, workers compensation claims, etc. I have the right, under the provisions of the Fair Credit Reporting Act and the Drivers Privacy Protection Act to request all such information from the reporting agency, upon proper identification, and to request the nature and substance of all information; and the receipt of any reports on me, which the reporting agency has, or will, furnish for the two preceding years. I am also entitled to a copy of my consumer rights under the Fair Credit Reporting Act. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the forgoing, unless it is in writing and signed by an authorized company representative.


   Review Form  
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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.

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Review your signature

Date: 2017-08-16 16:32:47

Click the Save - but don’t send button if you would like to return and complete your application at a later time. Your work will be saved but will not be sent to the HR Department yet

If you are finished with your application and would like to turn it in please click "Send". Once you Send it you will not be able to make any additional changes.