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Full Name*

Phone Number*

Email*

Date of Birth (DOB)*

Address*

City*

State*

Zip Code*

I have lived at this 'address longer than 2 years

I have a separate mailing address

I/My Driver can legally work within the United States of America*

Type of Trailer to be used (Enter "Power-Only" if no trailer)*

Number of citations or convictions for Reckless Driving or Careless Endangerment for the driver(last 3 years)*

I am able to provide maintenance records for the last 6 months*

I am able to provide vehicle inspection records upon requests*

The driver has never been denied for a license/permit to operate a motor vehilce*

Please explain why the driver has ever had a license or permit suspended or revoked*

I hereby agree that this data will be stored and processed for the purpose of establishing contact by First Step Freight and Logistics LLC or their affiliated partners. I am aware that I can revoke my consent at any time. I also attest that all information provided is accurate at the time of submitting this application, and I understand that any intentionally omitted or modified information may be grounds for terminating any current or future agreements.*

* Indicates required fields