JJ Keller 9645 - Confidential All-In-One Driver Qualification Packet (Two-Copy) - File Packet

Alert: Regulation Change to the Medical Examination Report Form, MCSA–5875 - Effective September 7, 2021
The updated form includes an OMB expiration date of 11/30/2021. As a result, we expect additional form changes from the OMB in the future.

• Allows you to keep Driver Qualification Forms, Alcohol & Drug Forms, and Safety Performance History Forms secure and in one convenient location
• Includes a 9-1/2" W x 11-3/4" L tabbed file folder and the following forms:
  • Driver Qualification
    • (1) Driver Qualification File Contents Sheet – Bond (*648-F-P)
    • (1) Checklist for Qualification of New Drivers – 2 Copy Bond (1 White/1 Canary) (*506541)
    • (1) Driver's Application for Employment – Bond (691)
    • (1) Request for Check of Driving Record – 2 Copy Bond (1 White/1 Canary) (*506540)
    • (1) Medical Examination Report – Bond (47375)
    • (1) Medical Examiner’s National Registry Verification – 2 Copy Bond (1 White/1 Canary) (27033)
    • (1) Record of Road Test – 2 Copy Bond (1 White/1 Canary) (652)
    • (1) Certification of Compliance with Driver License Requirements – 2 Copy Bond (1 White/1 Canary) (1617)
    • (1) Driver Statement of On-Duty Hours-New Hire – 2 Copy Bond (1 White/1 Canary) (3687)
    • (1) Certification of Violations/Annual Review of Driving Record – 2 Copy Bond (1 White/1 Canary) (3685)
    • (1) Employment Eligibility Verification (Form I-9) – Bond (50306)
    • (1) Certification of Road Test Pocket Card (006-BC)
    • (1) Driver Qualification and Identification Certificate Pocket Card (007-BC)
    • (1) Medical Examination Certificate – Laminated Wallet Card (47379)
  • Alcohol and Drug
    • (1) Previous Pre-employment Alcohol & Drug Test Statement - 2-Ply Snap-out (6801)
    • (1) Alcohol and Drug Records Request – 3-ply Snap-out (6826)
    • (1) Alcohol and Drug Employee's Certified Receipt - 2-Ply Snap-out (6793)
    • (1) Alcohol and/or Drug Test Notification - 2-Ply Snap-out (3048)
    • (1) Drug Test Results – 4-ply Snap-out (6794)
    • (1) Observed Behavior Reasonable Suspicion Record 3-ply Snap-out (7218)
    • (1) US Department of Transportation Alcohol Testing Form – 3-ply Snap-out (6849)
    • (1) Federal Drug Testing Custody and Control Form – 5-ply Continuous Pinfed (6520)
    • (1) Alcohol and Drug Recordkeeping Log – Bond (*001-F-P)
  • Safety Performance History
    • (3) Safety Performance History Records Request – 3-ply Snap-out (9620)
    • (1) Previous Employee Safety Performance History – 2 Copy Bond (1 White/1 Canary) (9620)

*Not sold separately