JJ Keller 9652 - Safety Performance History Records Request - Padded Format - Padded format, 8-1/2" x 11"
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JJ KELLER part description
- Use to help satisfy 49 CFR §391.23(a)(2), (d), and (e), which require the prospective employer to obtain driver identification, employment and accident history, and alcohol and drug testing information from a driver/applicant's previous employers
- Covers driver/applicant's authorization to release information; employment verification and accident information; and alcohol and drug test information
- Padded format, 50 sheets per pad
- Measures 8-1/2" W x 11" L
Interested in a license to use this form electronically?
For a quote to use this form electronically, such as on your company intranet, or with form-fillable fields, contact us at customsolutions@jjkeller.com or 1-800-327-6868 to discuss. Learn more.
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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