MVR RELEASE CONSENT FORM
In conjunction with my potential employment at BENEFIT TRUCKING INC (“the company”),
I hereby consent to the release of my Motor Vehicle Records (MVR) to the company.
I understand the company will use these records to evaluate my suitability to fulfill driving
evaluation, and other use of any MVR I may have provided to the company.
This consent is given in satisfaction of Public Law 18 USC 2721 et. Seq., “Federal Drivers
Privacy Protection Act”, and is intended to constitute “written consent” as required by this Act..
Drivers License Number
Drivers License StateChoose StateALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY
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Document Name: MVR
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Background Record Check
I hereby authorize Benefit Trucking inc. to request my driving/background records for purposes of investigation as required by Section 391.23 of the FMCSR. You are released from any and all liability which may result from furnishing such information.
In accordance with the provisions of Section 604 and 607 of the Fair Credit Reporting Act, Public Law 91‐ 508, as amended by the Consumer Credit Reporting Act of 1996 (Title II, Subtitle D, Chapter 1, of Public Law 104‐208), I hereby certify the following: