Employee Driver Declaration Form A driver must pass a medical examination and be issued a Medical Examiner s Certificate 49 CFR 391 41 For non CDL holders the carrier must keep a copy of the Medical Examiner s Certificate in the driver s qualification file For CDL holders the motor carrier employer must obtain the CDLIS MVR defined at 49 CFR 384 105
Company Vehicle DRIVER DECLARATION FORM Driver Details Driver Name Address Employee Yes No Practice Name Approved by I am over the age of 18 and have held a full driving licence for at least 12 months I am medically fit to drive I have read and understood the company s Vehicle and Driving Safety Policy and agree to follow Any circumstances affecting your ability to drive for work purposes or eligibility to hold necessary driving documents must be reported to your Line Manager immediately who will review your
Employee Driver Declaration Form
Employee Driver Declaration Form
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The Employer Pull Notice EPN program enables commercial and government organizations to monitor the driving records of employees who drive for them By monitoring their employees driving records organizations can Ensure that each driver has a valid driver s license Recognize problem drivers or driving behavior Improve public safety To be eligible for a company vehicle employees must complete a form and submit a copy of their driver s license Employees are only allowed to drive a company car if they have a valid driver s license and a clean driving record for at least X years A clean driving record means the employee has not been held at fault for a car accident
We recommend that you ask all your staff who drive for business to complete a declaration when they start their job and at least once per year during employment If driving is a significant part of the job you might decide to undertake the checks more frequently Use our Driver Declaration form to have evidence of your checks to hand Warning The drivers declaration form All drivers comply with the minimum eyesight standard for driving Rule 81 of highway code No N A Hazards Control Measures Yes No or N A Any Further Control Measures Needed The Driver Continued Anyone who is asked to drive as part of their job and is pregnant will be re assessed during the pregnancy to see
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Regularly good driver assessment and training system will include regular on going assessment of all drivers e g once a year to identify any new issues such as a change in driving style abilities or attitudes or a change in the driving tasks Specific or more frequent assessments are needed Driver Employment Application Company Name Address Phone Number and Email This is an example driver employment application Carriers do not need to use this exact form but must have a completed and signed employment application for all drivers that contains the information listed in 49 CFR 391 21
MOTOR VEHICLE DECLARATION FORM FOR TOOL OF TRADE AND OTHER BENETAS FLEET VEHICLES Benetas is committed to ensuring the health safety and welfare of its employees volunteers and others affected by its operation including members of the public Motor vehicles are considered to be a workplace under Occupational Health Our driver declaration form will help you to do this Why use it and when When there s a serious accident the police establish whether the driver was working If they were and there are concerns about aspects of the incident such as the employee s entitlement to drive they will investigate whether there was any wrongdoing by the employer
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Employee Driver Declaration Form - The drivers declaration form All drivers comply with the minimum eyesight standard for driving Rule 81 of highway code No N A Hazards Control Measures Yes No or N A Any Further Control Measures Needed The Driver Continued Anyone who is asked to drive as part of their job and is pregnant will be re assessed during the pregnancy to see